Our Summary

This research paper looked at the link between stroke and death in patients who have had coronary artery bypass grafting (CABG), a type of heart surgery. The study found that patients who suffered a stroke during or shortly after the surgery were 7.3 times more likely to die within 30 days than those who didn’t have a stroke. The death rate among patients who had a stroke was 14.4%, compared to 2.3% for those who didn’t. This suggests that there needs to be better monitoring and treatment of stroke in patients undergoing this type of heart surgery.

FAQs

  1. What is the link between stroke and death in patients who have had coronary artery bypass grafting (CABG)?
  2. What is the death rate among patients who had a stroke during or shortly after the CABG surgery?
  3. What does the study suggest about the need for better monitoring and treatment of stroke in patients undergoing CABG?

Doctor’s Tip

A helpful tip a doctor might tell a patient about CABG is to be aware of the potential risk of stroke during or shortly after the surgery. It is important to closely follow post-operative care instructions, attend follow-up appointments, and promptly report any symptoms of stroke, such as sudden weakness or numbness in the face, arm, or leg, difficulty speaking or understanding speech, and severe headache. Proper monitoring and treatment of stroke can help improve outcomes and reduce the risk of death after CABG surgery.

Suitable For

Patients who are typically recommended for CABG are those who have severe coronary artery disease that cannot be adequately treated with medications or less invasive procedures such as angioplasty. These patients may have:

  1. Severe blockages in multiple coronary arteries
  2. Left main coronary artery disease
  3. Severe blockages in the proximal portion of the left anterior descending artery
  4. Diabetes
  5. Previous heart attacks
  6. Poor heart function
  7. Unstable angina
  8. Chronic chest pain that limits daily activities

Ultimately, the decision to recommend CABG surgery is made on a case-by-case basis by a team of healthcare professionals, including cardiologists and cardiac surgeons, taking into consideration the patient’s overall health, severity of coronary artery disease, and risk factors for complications.

Timeline

Before CABG:

  1. Patient undergoes various tests and evaluations to determine the need for surgery, such as angiogram, stress test, and blood tests.
  2. Patient may be prescribed medications to manage symptoms and reduce the risk of complications.
  3. Patient receives counseling and education about the surgery, including risks and benefits.

During CABG:

  1. Patient is placed under general anesthesia.
  2. Surgeon makes an incision in the chest to access the heart.
  3. Diseased arteries are bypassed using grafts from other parts of the body.
  4. Surgery typically takes 3-6 hours to complete.
  5. Patient is closely monitored in the intensive care unit (ICU) immediately following surgery.

After CABG:

  1. Patient is transferred to a regular hospital room once stable.
  2. Patient undergoes physical therapy to regain strength and mobility.
  3. Patient is monitored for complications such as infection, bleeding, and stroke.
  4. Patient is prescribed medications to manage pain, prevent blood clots, and lower cholesterol.
  5. Patient participates in cardiac rehabilitation to improve heart health and overall well-being.

Overall, the recovery process after CABG can take several weeks to months, with the goal of improving heart function and reducing the risk of future heart problems.

What to Ask Your Doctor

  1. What are the risk factors for stroke during or after CABG surgery?
  2. What steps will be taken to monitor and prevent stroke during the surgery?
  3. What are the warning signs of stroke that I should be aware of after the surgery?
  4. How will stroke be treated if it occurs during or after the surgery?
  5. Are there any lifestyle changes or medications I can take to reduce my risk of stroke following CABG surgery?
  6. How often should I follow up with my doctor after the surgery to monitor for any signs of stroke?
  7. Are there any specific rehabilitation or physical therapy programs that can help prevent stroke after CABG surgery?
  8. What is the overall success rate of CABG surgery in preventing future cardiac events, including stroke?
  9. Are there any alternative treatment options to CABG surgery that may have a lower risk of stroke?
  10. What should I do if I experience any symptoms of stroke after the surgery?

Reference

Authors: Roy P, Brahme I, Reddy RP, Wechsler L, Gleason T, Thirumala PD. Journal: Neurologist. 2020 Sep;25(5):113-116. doi: 10.1097/NRL.0000000000000277. PMID: 32925480