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Invited Commentary
June 2018

Aortic Valve Surgery After Recent Stroke: Patience Is a Virtue

Author Affiliations
  • 1Department of Neurology, University of Pennsylvania, Philadelphia
  • 2Leonard Davis Institute of Heath Economics, University of Pennsylvania, Philadelphia
JAMA Cardiol. 2018;3(6):514-515. doi:10.1001/jamacardio.2018.0898

Stroke is an important and dreaded perioperative complication, with reported rates of less than 1% in general and noncarotid vascular surgery and higher rates in cardiac, carotid, and neurosurgical procedures. Cardiac valve replacement, an increasingly common procedure owing to the aging of the population and expanded treatment options, has among the highest reported risk of stroke, ranging from 2% to more than 10% depending on the cohort studied and ascertainment methodology.1,2 Prior studies in cardiac surgery have consistently shown that patients with a history of stroke are at an increased risk of perioperative stroke1; however, relatively little is known about the impact of time after stroke on operative risk of aortic valve replacement (AVR).