{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T08:21:13Z","timestamp":1770884473719,"version":"3.50.1"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Stroke is a potentially devastating complication of cardiac surgery. Identifying predictors of radiographic infarct may lead to improved stroke prevention for surgical patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We reviewed 129 postoperative brain magnetic resonance imagings from a prospective study of patients undergoing surgical aortic valve replacement. Acute infarcts were classified as watershed or embolic using prespecified criteria.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Acute infarct on magnetic resonance imaging was seen in 79 of 129 patients (61%), and interrater reliability for stroke pathogenesis was high (\u03ba=0.93). Embolic infarcts only were identified in 60 patients (46%), watershed only in 2 (2%), and both in 17 (13%). In multivariable logistic regression, embolic infarct was associated with aortic arch atheroma (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.0\u201312.0;\n              <jats:italic>P<\/jats:italic>\n              =0.055), old subcortical infarcts (OR, 5.5; 95% CI, 1.1\u201326.6;\n              <jats:italic>P<\/jats:italic>\n              =0.04), no history of percutaneous transluminal coronary angioplasty or coronary artery bypass graft (OR, 4.0; 95% CI, 1.2\u201313.7;\n              <jats:italic>P<\/jats:italic>\n              =0.03), and higher aortic valve gradient (OR, 1.3 per 5 mm\u2009Hg; 95% CI, 1.09\u20131.6;\n              <jats:italic>P<\/jats:italic>\n              =0.004). Watershed infarct was associated with internal carotid artery stenosis \u226570% (OR, 11.7; 95% CI, 1.8\u201376.8;\n              <jats:italic>P<\/jats:italic>\n              =0.01) and increased left ventricular ejection fraction (OR, 1.6 per 5% increase; 95% CI, 1.08\u20132.4;\n              <jats:italic>P<\/jats:italic>\n              =0.02).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>The principal mechanism of acute cerebral infarction after aortic valve replacement is embolism. There are distinct factors associated with watershed and embolic infarct, some of which may be modifiable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.116.013970","type":"journal-article","created":{"date-parts":[[2016,7,6]],"date-time":"2016-07-06T03:09:59Z","timestamp":1467774599000},"page":"2130-2132","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Pathogenesis and Risk Factors for Cerebral Infarct After Surgical Aortic Valve Replacement"],"prefix":"10.1161","volume":"47","author":[{"given":"Allie","family":"Massaro","sequence":"first","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven R.","family":"Mess\u00e9","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Acker","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott E.","family":"Kasner","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Torres","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Fanning","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania","family":"Giovannetti","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah J.","family":"Ratcliffe","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Bilello","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson Y.","family":"Szeto","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph E.","family":"Bavaria","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Emile R.","family":"Mohler","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas F.","family":"Floyd","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)01569-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005084"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.315105014"},{"key":"e_1_3_2_5_2","first-page":"584","article-title":"Characteristics of cerebrovascular accidents after coronary artery bypass grafting.","volume":"58","author":"Blossom GB","year":"1992","unstructured":"Blossom GB, Fietsam R, Bassett JS, Glover JL, Bendick PJ. Characteristics of cerebrovascular accidents after coronary artery bypass grafting. Am Surg. 1992;58:584\u2013589.","journal-title":"Am Surg"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000098650.12386.B3"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000138783.63858.62"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)00830-4"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03340210040022"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.220.1.r01jl09195"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.55.11.1475"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.116.013970","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T15:24:40Z","timestamp":1715613880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.116.013970"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":10,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1161\/STROKEAHA.116.013970"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.116.013970","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8]]},"assertion":[{"value":"2016-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-05-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}