The importance of preoperative magnetic resonance imaging in valve surgery for active infective endocarditis

Yasushi Takagi, Yoshiro Higuchi, Hiroshi Kondo, Kiyotoshi Akita, Michiko Ishida, Kan Kaneko, Ryo Hoshino, Masato Sato, Motomi Ando

研究成果: Article査読

8 被引用数 (Scopus)

抄録

Purpose: Valve surgery for active infective endocarditis (IE) can cause fatal brain hemorrhage. Our current study aimed to evaluate the incidence of septic cerebral lesions in active IE patients by performing preoperative magnetic resonance imaging (MRI) including T2- weighted sequences and magnetic resonance angiography (MRA) before urgent valve surgery, and to investigate whether such preoperative evaluation affects postoperative outcomes. Methods: Eighteen patients were referred to our department for native valve IE during 2006-2010. Urgent surgery was indicated in cases of hemodynamic failure resulting from valve destruction, refractory sepsis, and mobile vegetations measuring >10 mm. For these patients, we performed preoperative MRI and MRA. Results: Males comprised 67% of the subjects, with average age 53 ± 15 years. No clinical evidence of acute stroke was noted. Of the 18 patients, urgent surgery was indicated in 15; of these, 10 (67%) showed a brain lesion related to IE: 6 patients had acute or subacute brain infarctions, 2 patients had brain infarction with brain abscess, and 2 patients had hemorrhagic brain infarction and so did not undergo urgent surgery. Thus, 13 patients underwent urgent valve surgery. Among the 5 patients who did not undergo urgent surgery, 4 patients later underwent valve surgery for healed IE. No hospital deaths or neurological complications occurred. Conclusion: MRI of patients with active IE revealed a high incidence of cerebral lesions caused by IE. The use of MRI to detect septic embolism and intracerebral hemorrhage may provide important information for better surgical outcomes.

本文言語English
ページ(範囲)467-471
ページ数5
ジャーナルGeneral Thoracic and Cardiovascular Surgery
59
7
DOI
出版ステータスPublished - 01-07-2011

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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