Stroke debility during non-full sternotomy versus full sternotomy access cardiac valve operations.

• Tác giả: Ahmad S Abdelrazek, Arman Arghami, Juan A Crestanello, Richard C Daly, Kevin L Greason, Brian D Lahr, Alex Lee, Hartzell V Schaff, John M Stulak
• Ngôn ngữ: eng
• Thông tin xuất bản: Netherlands : JTCVS open , 2025
• Bộ sưu tập: NCBI
• ID: 683724

Tóm tắt

 OBJECTIVE: Previous studies have reported an increased risk of stroke with non-full sternotomy access during cardiac valve operations, but the clinical significance of these strokes has not yet been explored. We sought to determine the incidence and clinical magnitude of postoperative stroke following non-full versus full sternotomy access. METHODS: We analyzed the records of 12,406 patients who underwent a cardiac valve operation with full median sternotomy (n = 10,863
  88%), partial sternotomy (n = 219
  1.8%), or thoracotomy (n = 1324
  11%) access between January 1997 and March 2021. The primary outcome was permanent stroke, categorized using the modified Rankin Scale (mRS
  score 0-6) at discharge. Multivariable logistic regression analysis was used to assess the risk of stroke. RESULTS: The rate of stroke was 1.0% in the full sternotomy group, 2.7% in the partial sternotomy group, and 1.2% in the thoracotomy group ( CONCLUSIONS: Partial sternotomy versus full sternotomy is associated with increased risk of stroke, whereas thoracotomy versus full sternotomy is not. The risk of stroke is low, with most strokes being only mildly disabling.