Silent brain infarction after minimally invasive cardiac surgery with retrograde perfusion [post]

Shuhei Nishijima, Yoshitsugu Nakamura, Daiki Yoshiyama, Yuto Yasumoto, Miho Kuroda, Taisuke Nakayama, Ryo Tsuruta, Yujiro Ito, Fumiaki Shikata, Tetuji Takeda, Nobuyuki Kato
2020 unpublished
and aim: The incidence of symptomatic cerebral infarction after minimally invasive cardiac surgery (MICS) with retrograde perfusion has been increasing. However, there is no report about silent brain infarction (SBI) after MICS with retrograde perfusion. Because SBI may cause delirium and decline of cognitive function, this condition is important clinically. Thus, the current study aimed to investigate the occurrence of SBI after MICS via magnetic resonance imaging (MRI). Methods: Between July
more » ... 014 and July 2018, 174 patients underwent MICS with retrograde perfusion and postoperative MRI in this study. Univariate and multivariate analyses were performed to examine the occurrence of SBI and to identify its risk factors. Results: Of 174 patients, 26 (14.9%) presented with SBI. The univariate analysis revealed that age and aortic valve stenosis (AS) are the risk factors of SBI. Meanwhile, multivariate analysis revealed AS as the only risk factor of SBI. Conclusions: At our institution, the incidence of SBI after MICS with retrograde perfusion was acceptable. day 5. Some SBI might occurred postoperatively, not during the surgery. Conclusions The cause of SBI is associated with embolisms due to air and microdebris and the risk factor of SBI is AS. This study shows the low incidence of SBI after MICS. Thus, retrograde perfusion via the femoral artery may not increase incidence of SBI in selected MICS patients based on preoperative CT scan findings.
doi:10.22541/au.158981358.84615395 fatcat:745jbinsizhf7ciltp5s3vtw3i