Interventional Neuroradiology Expert Discusses Post-Surgical Stroke

This case involves a 25-year-old patient who suffered an ischemic stroke shortly after an aortic stent repair. The patient had a history of dilated cardiomyopathy, and he had received a heart transplant after reaching end-stage cardiac failure. Following this procedure, a covered CP stent was placed due to the discovery of aortic stenosis. However, shortly after it was implanted the stent fractured and a piece lodged in one of the patient’s extremities. It was recommended that stainless steel stents be placed inside the fractured stent to hold it in place. The procedure was completed, however, it was noted that the patient was disoriented and lethargic for an extended period post-surgery, and paralysis of the patient’s left side was also noted. A CT scan revealed a middle cerebral artery stroke. Since the surgery, the patient has suffered serious cognitive and neurological deficits from the stroke.

Question(s) For Expert Witness

Do you routinely treat patients like the one described in this case?

Based on the summary, is it possible that this patient might have had a better outcome had the care rendered been different?

Expert Witness Response E-000786

I am a board certified Neuroradiologist so I do routinely treat patients like the one described in this case. I have also published on the treatment of strokes in pediatric patients. Based on the summary of this case it appears that there was a troubling delay in treatment, a delay long enough to cause severe brain injury. I would happy to review the medical records to opine further. At first blush it does appear that if the care rendered were different the patient might have had a better outcome.