Clinical analysis and treatment of patients with cerebral infarction after cardiac surgery

Objective To analyse the timing of cerebral infarction after cardiac surgery, summarize the intensive care treatment and prognosisof patients with cerebral infarction, and provide the basis for clinical prevention and treatment of postoperative cerebral infarction. Methods A retrospective review of patients undergoing cardiac surgery between January 2014 and December 2016 in our department. Patients had the clinical manifestations of central nervous system injury within 7 days after surgery and confirmed cerebral infarction by CT or MRI examination. The cerebral infarction patients were divided into the on-pump and off-pump group, and the clinical data were compared between the two groups. Cerebral infarction was defined as any focal or global neurological deficits lasting for more than 24 hours. Cerebral infarction was classified as early cerebral infarction when it occurred less than 24 hours postoperatively, and delayed cerebral infarction when it occurred more than 24 hours postoperatively. Results In a total of 41 patients with cerebral infarction were included in the study. Early cerebral infarction occurred in 12 patients and delayed cerebral infarction occurred in 29 patients. The off-pump group patients had significantly lower risk of early cerebral infarction(P=0.01). All patients in this study were treated with comprehensive therapy. The time of on-pump and off-pump group staying in ICU was respectively(9.63±6.42 )days and(8.19±4.63)days, the total length of hospital stay was(24.25±13.51)days and(19.14±12.81)days, the difference was statistically significant(P<0.05). When discharged BI was severe disability in 8 cases, deterioration of discharged automatically in 4 cases, death in 1 cases. Conclusion Compared with patients undergoing off-pump CABG, patients undergoing on-pump surgery more frequently had early cerebral infarction. Early and delayed cerebral infarction differed in their mechanisms. Different preventive strategies should be applied in future intervention. Perioperative cerebral infarction seriously affected the patient's prognosis and quality of life. Key words: Cerebral infarction; Cardiac surgery; Intensive care