Table 2.

Maneuvers that could be used to decrease the incidence of stroke during cardiac surgery

Preoperative maneuvers	Intraoperative operative maneuvers	Postoperative maneuvers
Carotid artery screening and revascularization Individualize carotid artery stenting versus surgical revascularization Continue medical treatment with statins and antiplatelet medications	Aortic manipulation done after imaging ascending aorta Consider epiaortic ultrasound if images are suboptimal through TEE Identify accurately disease free aorta for cannulation and side clamping Practice OPCAB where possible Practice “no touch aortic technique” if possible	Prevent postoperative atrial fibrillation Initiate beta blockade early Commence therapy with statins

TEE: Transesophageal echocardiography, OPCAB: Offpump coronary artery bypass