sign is included the incidence would probably be nearer 5%. Most
of these focal deficits are caused by atheroembolism. Air, left atrial
thrombus and calcific valve debris are additional risk in valve
surgery. I quote the routine patient a risk of stroke of 1% to 2%
adjusted upwards for increasing age, history of previous stroke or
TIA, and hypertension, and adjusted down for relative youth.
The incidence of subtle diffuse or global brain injurydepends on
definition. Some difficulty with concentration and memory
affects about a quarter of patients – but very few are troubled by it
to any extent.^1
What is the risk of myocardial infarction?
This is extremely difficult to define. In good hands it rarely
complicates valve operations without coronary artery disease. In
coronary surgery incidence depends on definition but myocardial
dysfunction, local or global, is the commonest cause of death. The
incidence of infarction is entirely dependant on definition and
any figure from 2% to 10% could be given, depending on the
criteria used.
RReeffeerreennccee
1 Treasure T. Cerebral protection in adults. In: Yacoub M, Pepper J, eds.
Annual of cardiac surgery, 7th edition. London and Philadelphia: Current
Science, 1994: 161–9