Stroke risk of carotid stenosis and impaired cerebrovascular autoregulation at cardiac surgery with extracorporeal circulation

Aims: Carotid stenosis at cardiac surgery with cardiopulmonary bypass (CPBS) is linked to an increased stroke risk. We aimed to assess this risk in relation to the degree of stenosis and whether stenosis related haemodynamic compromise predicts perioperative stroke. Methods: 2809 of 7120 (39.5%) patients (pts) who underwent CPBS between Jan 1996 and Oct 2005 had carotid duplex before surgery (73.3% coronary artery bypass graft, 14.1% valve repair, 12.6% both). Transcranial Doppler with carbon dioxide testing for cerebrovascular reserve capacity was performed in all pts with high-grade stenosis (>/=80% local diam…