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Brain & Heart Thrombectomy for stroke after cardiac surgery

one had AF before surgery, emphasizing the important role Timely MT treatment has a beneficial effect on neurological
of AF in the development of LVO stroke. Three patients function and greatly improves patients’ prognosis.
had reduced ejection fraction (≤50%) after cardiac surgery Thus, given its advantages, the usage of multimodal CT
on echocardiography in this study. Heart failure is the evaluation should be promoted and popularized in clinical
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second leading cause of cardiogenic stroke, and the settings. Nevertheless, further studies employing larger
mechanisms of thromboembolic events in patients with sample sizes are warranted to improve the outcomes in this
heart failure include blood stasis, endothelial dysfunction, special patient cohort, since severe neurological deficits
and a hypercoagulable state. Therefore, greater attention and even mortality occur in certain patients receiving MT.
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should be paid to ischemic stroke in patients with impaired
cardiac function after cardiac surgery. Acknowledgments
The patients included in this study mainly underwent None.
CABG and valve surgery, as these two surgeries are the Funding
most common. In this study, most patients who underwent
thrombectomy had symptoms that occurred 2 – 5 days This work was supported by the National High-Level
after surgery, indicating that the diagnosis of stroke in these Hospital Clinical Research Funding (2022-GSP-TS-4).
patients can be made during the stable post-operative period
or when they wake up from general anesthesia. We found Conflict of interest
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that even if the patient had an in-hospital stroke, there was Shujuan Li is an Editorial Board Member of this journal but
still a long duration from LKW to recanalization. A scientific was not in any way involved in the editorial and peer-review
statement on in-hospital stroke reported that although process conducted for this paper, directly or indirectly.
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patients with in-hospital stroke had short admission process Separately, other authors declared that they have no known
and transfer times, their evaluation and treatment were often competing financial interests or personal relationships that
delayed compared to patients with community-onset stroke, could have influenced the work reported in this paper.
contributing to higher rates of morbidity and mortality in this
patient population. It is difficult to distinguish between a new Author contributions
stroke and the consequences of periprocedural medications. Conceptualization: Shujuan Li, Yao Feng
In addition, the in-hospital stroke treatment process needs Formal analysis: Yao Feng, Guitao Zhang
to be optimized, as there is still a long waiting time between Investigation: Guitao Zhang, Bin Lv
symptom discovery and entering the interventional therapy. Methodology: Na Zhao, Bincheng Wang
Addressing this requires collaboration among multiple Writing – original draft: Yao Feng, Bincheng Wang
hospital departments, including the cardiac surgery, Writing – review & editing: Shujuan Li, Bin Lv
radiology, neurology, interventional operating rooms, and
medical affairs departments. Ethics approval and consent to participate
This study has some limitations that must be noted. The Research Ethics Committee of Fuwai Hospital, Chinese
Firstly, the results need to be interpreted with caution, Academy of Medical Sciences, approved this study (Ethics
given the limited sample size. Secondly, we only reported approval code: 2022-1848). Data were collected retrospectively,
patients with LVO stroke who underwent MT; therefore, and no further procedure was performed; hence, the
the prognosis of patients with LVO stroke who did not requirement to obtain informed consent was waived.
undergo thrombectomy remains unclear. In addition, the
present study did not attempt to delineate whether patient Consent for publication
prognosis can be significantly improved (90-day mRS All images used in this study were anonymized; hence, the
score 0 – 1) when the diagnostic and treatment processes requirement to obtain consent for publication was waived.
are optimized, given the relatively long waiting time
between symptom discovery and treatment process. Availability of data
Nevertheless, our case series supplements the evidence for The data used in this study will be made available from the
MT in this special population and provides a reference for corresponding authors upon request.
future large-sample cohort studies.
References
5. Conclusion
1. Madeira M, Martins C, Koukoulis G, Marques M, Reis J,
The present study illustrates the impact of multimodal Abecassis M. Mechanical thrombectomy for stroke after
CT-guided MT on the prognosis of LVO stroke patients. cardiac surgery. J Card Surg. 2016;31:517-520.

Volume 3 Issue 1 (2025) 7 doi: 10.36922/bh.4141