Korean J Thorac Cardiovasc Surg.  2008 Dec;41(6):718-723.

Magnetic Resonance Angiographic Evaluation as a Screening Test for Patients who are Scheduled for Cardiac Surgery

• Suh JH
• Choi SY
• Kim YH

Abstract

BACKGROUND: The advances in surgical techniques, anesthesia management, perfusion methodology and postoperative intensive care have markedly decreased the mortality and cardiac morbidity of patients who undergo heart surgery over the past 2 decades. Nevertheless, it is well recognized that cardiac surgery carries a substantial risk for central nervous system complications. This study was conducted to evaluate the prevalence of subclinical cerebrovascular lesions in the head and neck by performing magnetic resonance angiography (MRA), and we investigated the clinical course of patients who had abnormal lesion seen on head and neck MRA. MATERIAL AND METHOD: The subjects were 107 patients (71 men and 36 women ranging in age from 21 to 83 years) who were scheduled for cardiac surgery under nonemergency conditions between October 2005 and June 2008. Informed consent was obtained before the MRA. The carotid arteries, intracranial arteries and brain parenchyme were examined for subclinical cerebrovascular lesions by performing MRA. We reviewed the patients' medical records and MR findings to evaluate the prevalence of neurologically high risk patients and their clinical course. RESULT: The overall prevalence of neurologically high risk patients was 15.7% (17 patients). Among these patients, 11 patients had ischemic heart disease and 6 patients had valvular heart disease. Only 2 patients had a history of cerebrovascular disease. The clinical courses of 14 patients (13.1%) were changed according to their MRI findings. CONCLUSION: The prevalence of subclinical cerebrovascular disease in patients who were scheduled for cardiac surgery was higher than was expected. MR angiography was of value to identify these patients.

Keyword

Cardiac; Magnetic resonance imaging; Brain; Preoperative care

MeSH Terms

Anesthesia
Angiography
Arteries
Brain
Carotid Arteries
Central Nervous System
Female
Head
Heart Valve Diseases
Humans
Informed Consent
Critical Care
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Male
Mass Screening
Medical Records
Myocardial Ischemia
Neck
Perfusion
Preoperative Care
Prevalence
Thoracic Surgery