General Thoracic and Cardiovascular Surgery

, Volume 62, Issue 10, pp 608–613

Prediction of early postoperative cerebral hemorrhage in infective endocarditis patients using magnetic resonance imaging

  • Suguru Ohira
  • Kiyoshi Doi
  • Hidetake Kawajiri
  • Masahiro Dohi
  • Tsunehisa Yamamoto
  • Taiji Watanabe
  • Kazunari Okawa
  • Hitoshi Yaku
Original Article

DOI: 10.1007/s11748-014-0416-8

Cite this article as:
Ohira, S., Doi, K., Kawajiri, H. et al. Gen Thorac Cardiovasc Surg (2014) 62: 608. doi:10.1007/s11748-014-0416-8

Abstract

Objective

To evaluate the relationship between preoperative magnetic resonance imaging (MRI) findings and the occurrence of postoperative intracranial hemorrhage (ICH) in infective endocarditis (IE) patients.

Methods

Between 2002 and 2012, 30 IE patients required surgical intervention. Four patients developed and 26 patients did not develop postoperative ICH. All patients underwent preoperative brain MRI. The presence of acute brain infarction was detected by diffusion-weighted imaging (DWI), and cerebral microbleeds were detected by T2*-weighted imaging.

Results

Two ICH(+) patients died of stroke. Preoperative patient characteristics and operative results were not significantly different. Regarding MRI findings, the presence of cerebral microbleeds or acute brain infarction alone was not significantly different between the two groups (100 vs. 29.6 %, p = 0.07; 75.0 vs. 38.5 %, p = 0.37, respectively). The concurrent presence of cerebral microbleeds and acute brain infarction was significantly correlated with the development of major ICH (75 vs. 14.8 %, p = 0.04). In multiple logistic regression analyses, the concurrent presence of cerebral microbleeds and acute brain infarction on MRI was an independent predictor of major postoperative ICH (p = 0.03, odds ratio 16.5, 95 % confidence interval 1.35–201.3).

Conclusion

The combination of T2*-weighted MRI and DWI may be useful to evaluate the risk of IE patients developing major postoperative cerebral bleeding.

Keywords

Infective endocarditis Cerebral hemorrhage Magnetic resonance imaging 

Copyright information

© The Japanese Association for Thoracic Surgery 2014

Authors and Affiliations

  • Suguru Ohira
    • 1
  • Kiyoshi Doi
    • 1
  • Hidetake Kawajiri
    • 1
  • Masahiro Dohi
    • 1
  • Tsunehisa Yamamoto
    • 1
  • Taiji Watanabe
    • 1
  • Kazunari Okawa
    • 1
  • Hitoshi Yaku
    • 1
  1. 1.Department of Cardiovascular SurgeryKyoto Prefectural University of MedicineKyotoJapan

Personalised recommendations