Volume 10,Issue 1
Fall 2025
Comprehensive Treatment Strategies for “Cardiac-Cerebral Comorbidities” in Cardiovascular
The comorbidity of cardiovascular diseases and neurological disorders (referred to as “cardiac-cerebral comorbidities”) is receiving increasing attention in the field of cardiovascular surgery. The “heart-brain synergy” strategy, as a comprehensive treatment concept, emphasizes the interaction and balance between the heart and brain, offering a novel perspective for the simultaneous treatment of “cardiac-cerebral comorbidities.” This article focuses on common conditions in cardiovascular surgery and their perioperative neurological complications, elucidating the “heart-brain synergy” strategy to provide clinical practitioners with more scientific and effective treatment guidance.
1. Song Y, Liu L, Jiang B, 2022, Risk Factors of Cerebral Complications After Stanford Type A Aortic Dissection Undergoing Arch Surgery. Asian Journal of Surgery, 45(1): 456–460. https://doi.org/10.1016/j.asjsur.2021.07.071
2. Zilla P, Bolman RM 3rd, Boateng P, et al., 2020, A Glimpse of Hope: Cardiac Surgery in Low- And Middle-Income Countries (LMICs). Cardiovasc Diagn Ther, 10(2): 336–349. https://doi.org/10.21037/cdt.2019.11.03
3. Marcin T, Eser P, Prescott E, et al., 2020, Predictors of Pre-Rehabilitation Exercise Capacity in Elderly European Cardiac Patients – The EU-CaRE Study. Eur J Prev Cardiol, 27(16): 1702–1712. https://doi.org/10.1177/2047487319894676
4. Liberale L, Ministrini S, Carbone F, et al., 2021, Cytokines as Therapeutic Targets for Cardio- and Cerebrovascular Diseases. Basic Res Cardiol, 116(1): 23. https://doi.org/10.1007/s00395-021-00863-x
5. Li X, Zong L, Ni L, et al., 2021, Experience of Coronary Artery Bypass Grafting Combined with Carotid Endarterectomy in the Treatment of Coronary Heart Diseases and Carotid Stenosis. Journal of Clinical Cardiology, 37(8): 772–775. https://doi.org/10.13201/j.issn.1001-1439.2021.08.020
6. Kihara S, Shimakura T, Tanaka SA, et al., 2001, Staged Coronary Artery Bypass Grafting After Percutaneous Angioplasty for Intracranial Vascular Stenosis. J Thorac Cardiovasc Surg, 122(3): 608–10. https://doi.org/10.1067/mtc.2001.115159
7. Paraskevas KI, Nduwayo S, Saratzis AN, et al., 2017, Carotid Stenting Prior to Coronary Bypass Surgery: An Updated Systematic Review and Meta-Analysis. Eur J Vasc Endovasc Surg, 53(3): 309–319. https://doi.org/10.1016/j.ejvs.2016.12.019
8. Laimoud M, Maghirang M, Alanazi M, et al., 2022, Predictors and Clinical Outcomes of Post-Coronary Artery Bypass Grafting Cerebrovascular Strokes. Egypt Heart J, 74(1): 76. https://doi.org/10.1186/s43044-022-00315-4. Erratum in Egypt Heart J, 74(1): 79. https://doi.org/10.1186/s43044-022-00318-1
9. Tarasova I, Trubnikova O, Kupriyanova DS, et al., 2023, Cognitive Functions and Patterns of Brain Activity in Patients after Simultaneous Coronary and Carotid Artery Revascularization. Front Hum Neurosci, 17: 996359. https://doi.org/10.3389/fnhum.2023.996359
10. Meng SP, Hu YL, Ding FY, et al., 2018, Coronary Artery Lesion and Carotid Atherosclerosis as well as Cerebral Infarction. Chinese Journal of Clinical Cardiology, 34: 987–989.
11. Jia S, Wang M, Gong M, et al., 2022, Midterm Outcomes of Simultaneous Carotid Revascularization Combined with Coronary Artery Bypass Grafting. BMC Cardiovasc Disord, 22(1): 535. https://doi.org/10.1186/s12872-022-02986-y
12. Aksoy ÖN, Nazlı Y, 2022, Early-Term Outcomes of Simultaneous Carotid Endarterectomy and Coronary Revascularization. Cardiovasc Surg Interv, 9(3): 176–180. https://doi.org/10.5606/e-cvsi.2022.1278
13. Bai L, Ge L, Zhang Y, et al., 2023, Experience of the Postoperative Intensive Care Treatment of Stanford Type A Aortic Dissection. Int J Clin Pract, 2023(1): 4191277. https://doi.org/10.1155/2023/4191277
14. Bassano C, Pugliese M, Mve Mvondo C, et al., 2022, Initial Surgical Strategy for the Treatment of Type A Acute Aortic Dissection: Does Proximal or Distal Extension of the Aortic Resection Influence the Outcomes? Int J Environ Res Public Health, 19(14): 8878. https://doi.org/10.3390/ijerph19148878
15. Liu C, Xue Y, Chen Y, et al., 2021, Analysis of Surgical Treatment Effect for Patients with Acute Type A Aortic Dissection Complicated with Cerebral Ischemia Before Operation. Chinese Journal of Extracorporeal Circulation, 2021(19): 131–135.
16. Shen K, Tan L, Tang H, et al., 2022, Total Arch Replacement with Frozen Elephant Trunk Using a New “Brain-Heart-First” Strategy for Acute DeBakey Type I Aortic Dissection can be Performed Under Mild Hypothermia (≥ 30°C) with Satisfactory Outcomes. Front Cardiovasc Med, 9: 806822. https://doi.org/10.3389/fcvm.2022.806822
17. Shimizu K, Usuda M, Kakizaki Y, et al., 2023, Cerebral Infarction by Paradoxical Gas Embolism Detected after Laparoscopic Partial Hepatectomy with an Insufflation Management System: A Case Report. Surg Case Rep, 9: 34. https://doi.org/10.1186/s40792-023-01611-0
18. Egashira S, Doijiri R, Endo H, et al., 2022, Detection of Secondary Atrial Fibrillation Following Percutaneous Foramen Ovale Closure for Cryptogenic Stroke Using an Insertable Cardiac Monitor: A Case Report. Rinsho Shinkeigaku, 62(10): 787–792. https://doi.org/10.5692/clinicalneurol.cn-001781
19. Szabo TM, Heidenhoffer E, Kirchmaier Á, et al., 2022, Cor Triatriatum Sinister Presenting as Cardioembolic Stroke in a Young Woman. Diagnostics (Basel), 13(1): 97. https://doi.org/10.3390/diagnostics13010097
20. Zhang W, Sun H, Liu Z, et al., 2018, Clinical Diagnosis and Endovascular Treatment of Paradoxical Cerebral Embolism. Medical Information, 2018(31): 179–181.
21. Salem M, Hillmer J, Friedrich C, et al., 2022, Cardiac Myxomas Resembling Malignant Neoplasia: Incidentally Diagnosed vs. Cerebral Embolized Myxomas. Cancers (Basel), 14(15): 1111.
22. Ran H, Chen G, Hu J, et al., 2022, Case Report: Biatrial Myxoma With Pulmonary Embolism and Cerebral Embolism: Clinical Experience and Literature Review. Front Cardiovasc Med, 9: 812765. https://doi.org/10.3389/fcvm.2022.812765