CHEST 2023 On Demand Pass-It's Just Heart Surgery: What Could Possibly Go Wrong?

Video Transcription

Video Summary

The transcript discusses the incidence, classification, and recognition of stroke after cardiac surgery, specifically focusing on large vessel occlusion (LVO) syndrome. Perioperative stroke or TIA after cardiac surgery is common, with estimates varying widely. The transcript distinguishes between infarcts and stroke, emphasizing that stroke is a clinical diagnosis and that radiographically proven infarcts can often be clinically silent. Stroke after cardiac surgery is primarily due to cardio-aortic thromboembolism and can also be caused by border zone infarcts. It highlights the importance of recognizing stroke symptoms, particularly in post-operative AFib patients, who are at a higher risk. The transcript further emphasizes the significance of large vessel occlusion, which accounts for about 20% of strokes and is treated differently based on the mechanism. Thrombectomy is recommended for LVO up to 24 hours based on the latest evidence. The American Heart Association guidelines have been updated to reflect this and thrombectomy is considered class 1A recommendation for anterior circulation LVOs within six hours and 2A within 16 to 24 hours. The transcript concludes by discussing the importance of timely recognition of LVO and the potential for intervention to improve patient outcomes.

Meta Tag

Category Cardiothoracic Surgery

Session ID 1165

Speaker Casey Bryant

Speaker Matthew Gordon

Speaker Koto Ishida

Track Cardiothoracic Surgery

Keywords

stroke after cardiac surgery

large vessel occlusion syndrome

perioperative stroke

TIA after cardiac surgery

infarcts and stroke

clinical diagnosis

cardio-aortic thromboembolism

recognizing stroke symptoms

thrombectomy for LVO