Calderon Pinon, Christian

Wu, James K., MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works Research Scholars Analysis of Major Causes of Stroke Among Patients which Underwent Isolated Coronary Artery Bypass Grafting Christian Calderon Pinon James K. Wu MD Follow this and additional works at: https://scholarlyworks.lvhn.org/research-scholars  Part of the Medicine and Health Sciences Commons This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. Lehigh Valley Health Network, Allentown, Pennsylvania• Objective: To analyze the main causes of post-op stroke among patients who undergo isolated CABG procedure.• This project will aim to highlight:• Most important factors that lead to stroke• Most common diagnosed heart diseases that lead to stroke• Coronary Artery Bypass Grafting (CABG) is a procedure which aims to improve the blood flow of patients with heart diseases• Of all the patients who underwent isolated CABG procedure ~20% of them had post operational stroke• Decreasing mortality rate (~3%) 1 but high risk of complications and re-hospitalization 2 years following a CABG procedure (~33%) 2 (Hawkes et al.)References1&2. Hawkes, Anna Louise, et al. “Outcomes of Coronary Artery Bypass Graft Surgery.” Vascular Health and Risk Management, vol. 2, no. 4, Dec. 2006, pp. 477–484, https://doi.org/10.2147/vhrm.2006.2.4.477.3. Ibrahim, Faisal, and Najib Murr. “Embolic Stroke.” Nih.gov, StatPearls Publishing, 21 Oct. 2021, www.ncbi.nlm.nih.gov/books/NBK564351/#:~:text=Risk%20factors%20include%20hypertension%2C%20diabetes. Accessed 25 July 2023.4. Reddy, Vivek Y, et al. “Permanent Percutaneous Carotid Artery Filter to Prevent Stroke in Atrial Fibrillation Patients.” Journal of the American College of Cardiology, vol. 74, no. 7, 1 Aug. 2019, pp. 829–839, https://doi.org/10.1016/j.jacc.2019.04.035. Accessed 27 July 2023.Special thanks to James Wu, MD, Ahmed Nassar MD, Bryan Nelson, and LVHN Cedar CrestBackgroundMethodsResultsConclusionsRecommendations & Future DirectionsAnalysis of Major Causes of Stroke Among Patients which Underwent Isolated Coronary Artery Bypass GraftingChristian Calderon Pinon1, James K. Wu, M.D2• Retrospective look on patients who underwent isolated CABG procedure since 2019. CABG procedures with other procedure will not be included• Admission diagnosis and outcomes of the surgery which include complications, atrial fibrillation, medications used, etc.• Most common causes surrounding patients with post surgical stroke as well as integrating the data to demonstrate the most common factors behind cerebrovascular accidents (CVA)• Further analysis must be done to determine the exact outcome of patients with post-surgical CVA which could help in determining subsequent mortality and morbidity• A possible way to prevent post-op stroke in patients who underwent atrial fibrillation is to use a permanent percutaneous carotid artery filter which has been shown to demonstrate success in 92% patients who were unable to take oral anticoagulants and underwent the clinical trials. Nonetheless this is was a pilot study which will require larger studies in the future4 (Reddy et al.)• Efforts must be made to improve outreach to the patients in suggesting general lifestyle changes as well as making the screening for stroke more prevalent in patients at high risk of atrial fibrillation and subsequent stroke• The main cause of stroke that affects the patient population is embolism which is primarily attributed to atrial fibrillation as well as other major causes such as recent myocardial infarction, dilated cardiomyopathy, existence of a mechanical prosthetic valve, and mitral rheumatic stenosis3 (Ibrahim and Murr)• Due to the high median age of the patients as well as existing heart issues in which the patients were admitted as detailed in figure 3, the risk of stroke significantly increases. yet it is atrial fibrillation and recent myocardial infarction which are the main determinants of post-operative stroke in the patient populationFigure 1 (above): Major causes of stroke in patient populationFigure 3 (above): Admission diagnosis of patient population34%66%Atrial FibrillationYes NoFigure 2 (above): Percentage of atrial fibrillation in patient populationClassifyReviewAnalyze1 Summer Research Scholar2 LVH Department of Cardiothoracic Surgery (Cardiothoracic Surgeon)024681012NSTEMI (non-STelevated myocardialinfarction)CAD (coronary arterydisease)Cardiogenic shock STEMI (ST elevatedmyocardialinfarction)Other/UnknownAdmission diagnosis16101 1 1024681012141618Embolism/ischemia Atrial fibrillation Hemorrhagic Other UnknownCauses of Stroke

Analysis of Major Causes of Stroke Among Patients which Underwent Isolated Coronary Artery Bypass Grafting

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Analysis of Major Causes of Stroke Among Patients which Underwent Isolated Coronary Artery Bypass Grafting

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