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1.
Korean Journal of Anesthesiology ; : 332-333, 2018.
Article Dans Anglais | WPRIM | ID: wpr-716339

Résumé

No abstract available.


Sujets)
Hyperhomocystéinémie , Accident vasculaire cérébral
3.
Journal of Stroke ; : 157-168, 2016.
Article Dans Anglais | WPRIM | ID: wpr-43712

Résumé

Cerebrovascular complications after orthotopic heart transplantation (OHT) are more common in comparison with neurological sequelae subsequent to routine cardiac surgery. Ischemic stroke and transient ischemic attack (TIA) are more common (with an incidence of up to 13%) than intracranial hemorrhage (2.5%). Clinically, ischemic stroke is manifested by the appearance of focal neurologic deficits, although sometimes a stroke may be silent or manifests itself by the appearance of encephalopathy, reflecting a diffuse brain disorder. Ischemic stroke subtypes distribution in perioperative and postoperative period after OHT is very different from classical distribution, with different pathogenic mechanisms. Infact, ischemic stroke may be caused by less common and unusual mechanisms, linked to surgical procedures and to postoperative inflammation, peculiar to this group of patients. However, many strokes (40%) occur without a well-defined etiology (cryptogenic strokes). A silent atrial fibrillation (AF) may play a role in pathogenesis of these strokes and P wave dispersion may represent a predictor of AF. In OHT patients, P wave dispersion correlates with homocysteine plasma levels and hyperhomocysteinemia could play a role in the pathogenesis of these strokes with multiple mechanisms increasing the risk of AF. In conclusion, stroke after heart transplantation represents a complication with considerable impact not only on mortality but also on subsequent poor functional outcome.


Sujets)
Humains , Fibrillation auriculaire , Encéphalopathies , Transplantation cardiaque , Coeur , Homocystéine , Hyperhomocystéinémie , Incidence , Inflammation , Hémorragies intracrâniennes , Accident ischémique transitoire , Mortalité , Manifestations neurologiques , Plasma sanguin , Période postopératoire , Accident vasculaire cérébral , Chirurgie thoracique
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