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Stroke is a recognized perioperative complication in cardiac surgery patients. Some surgeons routinely image the carotid arteries of patients who are scheduled for cardiac surgery, presumably to identify patients in whom prophylactic carotid endarterectomy might prevent perioperative strokes. However, this practice is controversial.
In a retrospective study, researchers identified 3942 patients at one hospital in Pennsylvania who underwent carotid ultrasonography prior to coronary artery bypass grafting, aortic valve replacement, or both. Carotid stenosis that exceeded 50% was identified in 239 patients (6%), only 5 of whom had suffered previous cerebrovascular events.
Overall, 76 patients (2%) had strokes after cardiac surgery; nearly all we…