Impact of perioperative infarcts after cardiac surgery
Background and Purpose: Brain injury after cardiac surgery is a serious concern for patients and their families. The purpose of this study was to use 3-T fluid attenuated inversion recovery MRI to characterize new and preexisting cerebral ischemic lesions in patients undergoing cardiac surgery and t...
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| Format: | Article |
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American Heart Association
2015
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| Online Access: | https://eprints.nottingham.ac.uk/31953/ |
| _version_ | 1848794304466649088 |
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| author | Patel, Nikil Horsfield, Mark A. Banahan, Caroline Janus, Justyna Masters, Katie Morlese, John Egan, Vincent Chung, Emma M.L. |
| author_facet | Patel, Nikil Horsfield, Mark A. Banahan, Caroline Janus, Justyna Masters, Katie Morlese, John Egan, Vincent Chung, Emma M.L. |
| author_sort | Patel, Nikil |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background and Purpose: Brain injury after cardiac surgery is a serious concern for patients and their families. The purpose of this study was to use 3-T fluid attenuated inversion recovery MRI to characterize new and preexisting cerebral ischemic lesions in patients undergoing cardiac surgery and to test whether the accumulation of new ischemic lesions adversely affects cognition.
Methods: Digital comparison of before and after fluid attenuated inversion recovery MRI images was performed for 77 cardiac surgery patients. The burden of preexisting versus new ischemic lesions was quantified and compared with the results of baseline and postoperative neuropsychological testing.
Results: After surgery, new lesions were identified in 31% of patients, averaging 0.5 lesions per patient (67 mm3 [0.004%] of brain tissue). Patients with preexisting lesions were 10× more likely to receive new lesions after surgery than patients without preexisting lesions. Preexisting ischemic lesions were observed in 64% of patients, averaging 19.4 lesions (1542 mm3 [0.1%] of brain tissue). New lesions in the left hemisphere were significantly smaller and more numerous (29 lesions; median volume, 44 mm3; volume range, 5–404 mm3) than those on the right (10 lesions; median volume, 128 mm3; volume range, 13–1383 mm3), which is consistent with a cardioembolic source of particulate emboli. Overall, the incidence of postoperative cognitive decline was 46% and was independent of whether new lesions were present.
Conclusions: New lesions after cardiac surgery added a small (≈4%) contribution to the burden of preexisting cerebrovascular disease and did not seem to affect cognitive function. |
| first_indexed | 2025-11-14T19:14:04Z |
| format | Article |
| id | nottingham-31953 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:14:04Z |
| publishDate | 2015 |
| publisher | American Heart Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-319532020-05-04T17:03:07Z https://eprints.nottingham.ac.uk/31953/ Impact of perioperative infarcts after cardiac surgery Patel, Nikil Horsfield, Mark A. Banahan, Caroline Janus, Justyna Masters, Katie Morlese, John Egan, Vincent Chung, Emma M.L. Background and Purpose: Brain injury after cardiac surgery is a serious concern for patients and their families. The purpose of this study was to use 3-T fluid attenuated inversion recovery MRI to characterize new and preexisting cerebral ischemic lesions in patients undergoing cardiac surgery and to test whether the accumulation of new ischemic lesions adversely affects cognition. Methods: Digital comparison of before and after fluid attenuated inversion recovery MRI images was performed for 77 cardiac surgery patients. The burden of preexisting versus new ischemic lesions was quantified and compared with the results of baseline and postoperative neuropsychological testing. Results: After surgery, new lesions were identified in 31% of patients, averaging 0.5 lesions per patient (67 mm3 [0.004%] of brain tissue). Patients with preexisting lesions were 10× more likely to receive new lesions after surgery than patients without preexisting lesions. Preexisting ischemic lesions were observed in 64% of patients, averaging 19.4 lesions (1542 mm3 [0.1%] of brain tissue). New lesions in the left hemisphere were significantly smaller and more numerous (29 lesions; median volume, 44 mm3; volume range, 5–404 mm3) than those on the right (10 lesions; median volume, 128 mm3; volume range, 13–1383 mm3), which is consistent with a cardioembolic source of particulate emboli. Overall, the incidence of postoperative cognitive decline was 46% and was independent of whether new lesions were present. Conclusions: New lesions after cardiac surgery added a small (≈4%) contribution to the burden of preexisting cerebrovascular disease and did not seem to affect cognitive function. American Heart Association 2015-02-03 Article PeerReviewed Patel, Nikil, Horsfield, Mark A., Banahan, Caroline, Janus, Justyna, Masters, Katie, Morlese, John, Egan, Vincent and Chung, Emma M.L. (2015) Impact of perioperative infarcts after cardiac surgery. Stroke, 46 (3). pp. 680-686. ISSN 1524-4628 cerebral infarction magnetic resonance imaging neuropsychology thoracic surgery http://stroke.ahajournals.org/content/46/3/680 doi:10.1161/STROKEAHA.114.007533 doi:10.1161/STROKEAHA.114.007533 |
| spellingShingle | cerebral infarction magnetic resonance imaging neuropsychology thoracic surgery Patel, Nikil Horsfield, Mark A. Banahan, Caroline Janus, Justyna Masters, Katie Morlese, John Egan, Vincent Chung, Emma M.L. Impact of perioperative infarcts after cardiac surgery |
| title | Impact of perioperative infarcts after cardiac surgery |
| title_full | Impact of perioperative infarcts after cardiac surgery |
| title_fullStr | Impact of perioperative infarcts after cardiac surgery |
| title_full_unstemmed | Impact of perioperative infarcts after cardiac surgery |
| title_short | Impact of perioperative infarcts after cardiac surgery |
| title_sort | impact of perioperative infarcts after cardiac surgery |
| topic | cerebral infarction magnetic resonance imaging neuropsychology thoracic surgery |
| url | https://eprints.nottingham.ac.uk/31953/ https://eprints.nottingham.ac.uk/31953/ https://eprints.nottingham.ac.uk/31953/ |