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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Magnetic Resonance Imaging for Cerebral Micro-embolizations During Minimally Invasive Mitral Valve Surgery

Cristina Barbero1, Mauro Rinaldi2, Giovanni Marchetto2

  • 1Department of Cardiovascular and Thoracic Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy. cristina.barbero@unito.it.

Journal of Cardiovascular Translational Research
|November 30, 2021
PubMed

Insights

Silent cerebral micro-embolizations (SCM) after minimally invasive mitral valve surgery occur in about 30% of patients. Both endoaortic clamp and trans-thoracic clamp techniques showed comparable safety and SCM rates.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Medical Imaging

Background:

  • Neurological complications, including silent cerebral micro-embolizations (SCM), are a concern after mitral valve surgery.
  • The impact of different aortic clamping techniques on SCM in minimally invasive procedures remains unclear.

Purpose of the Study:

  • To determine the overall incidence of SCM following right mini-thoracotomy mitral valve surgery.
  • To compare the rates of SCM between endoaortic clamp (EAC) and trans-thoracic clamp (TTC) techniques.

Main Methods:

  • Prospective study involving 43 patients undergoing minimally invasive mitral valve surgery.
  • Pre-operative, post-operative, and follow-up MRI scans were used to detect SCM.
  • Patients were divided into two groups: EAC (n=21) and TTC (n=22).

Main Results:

  • Post-operative SCM were identified in 12 patients (27.9% overall incidence).
  • No significant difference in SCM rates was observed between the EAC group (23.8%) and the TTC group (31.8%).
  • MRI analysis confirmed SCM in approximately 30% of patients, with comparable results between clamping methods.

Conclusions:

  • Minimally invasive mitral valve surgery is associated with a notable rate of SCM, consistent with findings in traditional sternotomy approaches.
  • Both EAC and TTC are safe aortic clamping techniques for this procedure, with no difference in SCM occurrence.
  • Surgical approach selection should be individualized based on patient characteristics rather than clamping technique preference.
Keywords:
Cardiac diseaseMagnetic resonance imagingMitral valveMitral valve regurgitation

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