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