Visualising myocardial injury after noncardiac surgery: a case series using postoperative cardiovascular MRI

Dominik P Guensch1, Jan O Friess2, Sandra Stiffler2

  • 1Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

PubMed

Insights

Myocardial injury after noncardiac surgery (MINS) is a genuine cardiac event, not just a troponin rise. Cardiovascular magnetic resonance imaging shows significant myocardial edema in patients with MINS, confirming acute injury.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiovascular Surgery

Background:

  • Myocardial injury after noncardiac surgery (MINS) and perioperative myocardial injury are linked to higher morbidity and mortality.
  • Diagnosis relies on troponin increase, but the nature of MINS as a true myocardial insult remains debated.

Observation:

  • Postoperative cardiovascular magnetic resonance T2 mapping was used to visualize acute myocardial injury (edema).
  • Six patients with cardiovascular risk factors undergoing aortic surgery were studied.

Findings:

  • Patients qualifying for MINS exhibited a substantially higher burden of myocardial edema compared to those without MINS.
  • The imaging data provides visual evidence supporting MINS as a genuine myocardial injury.

Implications:

  • These findings suggest MINS is a true myocardial insult, not merely a biomarker elevation.
  • Understanding MINS as genuine injury could refine perioperative cardiac risk assessment and management strategies.