Heart disease and stroke are two major, worldwide causes of death and disability that mainly affect the elderly population. Neurological events related to cardiac surgeries influence health related quality of life as well as the postoperative survival. Pathophysiological mechanism of neurological injury during or after coronary artery bypass grafting is defined by various factors including hemodynamic compromise to embolization. Cardiac rehabilitation has been studied extensively in the population who underwent coronary artery bypass grafting, and regular exercise was found effective on improving the functional status, which is important for preventing progressive worsening of coronary artery disease, and avoiding hospitalizations. We reviewed the literature to update our knowledge about stroke related to coronary artery bypass grafting. A PubMed search was performed for studies relating to stroke during or after coronary artery bypass grafting from 2005 to 2015. Publications were retrieved by using search terms for stroke, neurologic event, and coronary artery bypass grafting. References cited in those articles were also culled for additional studies. No filters were applied to limit the retrieval by study type. Nowadays coronary angiography and percutaneous coronary intervention are considered to be safe interventions with low complication rates but we know that their usage in elderly has a higher risk for complications that include periprocedural stroke affecting many patients undergoing coronary angiography and percutaneous coronary intervention. Coronary artery bypass grafting is considered superior to percutaneous coronary intervention in reducing mortality, angina, recurrent myocardial infarction, and repeat revascularization procedures, especially in certain patients such as with diabetes and multivessel coronary artery disease. It is showed that the elderly have benefit from coronary artery bypass grafting over conservative treatment, and a postoperative life expectancy sometimes exceeding that of the general population. Patients need to adopt an individualized and feasible exercise routine after coronary artery bypass grafting surgery to achieve maximal recovery benefit and prevent progressive atherosclerotic disease.
STROKE RELATED TO CORONARY ARTERY BYPASS GRAFTING