Related Experiment Video

Updated: Jan 29, 2026

An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
15:04

An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery

Published on: February 17, 2018

12.7K

Risk Assessment in Cannulation for Minimally Invasive Heart Valve Surgery: The Modified HOSTILE Score

Jacqueline Kruse1, Miriam Silaschi1, Michael Celik1

  • 1Department of Cardiac Surgery, University Hospital Bonn, 53127 Bonn, Germany.

Journal of Clinical Medicine
|January 28, 2026
PubMed

Insights

The MOD-HOSTILE score helps predict stroke and neurological complications in minimally invasive heart valve surgery. Scores of 5 or higher indicate increased risk, suggesting alternative surgical approaches may be beneficial.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Medical Imaging

Background:

  • Transcatheter valve therapy and minimally invasive valve surgery share vascular access challenges.
  • Computed tomography (CT)-based planning is crucial for assessing these vascular issues.
  • The HOSTILE score was initially developed for transcatheter procedures.

Purpose of the Study:

  • To adapt the HOSTILE score for surgical use (MOD-HOSTILE) in minimally invasive heart valve surgery.
  • To evaluate the association of the MOD-HOSTILE score with neurological and adverse outcomes.
  • To assess the predictive value of MOD-HOSTILE for stroke risk.

Main Methods:

  • A single-center retrospective study of 364 patients undergoing minimally invasive heart valve surgery (2019-2023).
  • Calculation of the MOD-HOSTILE score (0-11 points) and patient stratification into low (0-2), mild (>2-5), and high (>5-11) categories.
  • Analysis of 30-day stroke, neurological events, perioperative complications, and mortality in relation to MOD-HOSTILE scores.

Main Results:

  • High MOD-HOSTILE scores correlated with older age and higher surgical risk (EuroSCORE II).
  • Neurological complications, including stroke and hemiplegia, were significantly more frequent in the high MOD-HOSTILE group.
  • High MOD-HOSTILE scores, particularly with axillary cannulation, were associated with the highest stroke risk (18.2%).
  • The MOD-HOSTILE score predicted stroke with an AUC of 0.78.

Conclusions:

  • The MOD-HOSTILE score effectively identifies vascular and neurological risks in minimally invasive valve surgery.
  • Scores of 5 or greater are linked to an elevated risk of stroke and delirium.
  • Patients with high MOD-HOSTILE scores may benefit from alternative surgical strategies to mitigate risks.

Keywords:
CT imagingminimally invasive heart valve surgeryrisk assessment

More Related Videos

Viral Transgene Expression in Rodent Hearts and the Assessment of Cardiac Arrhythmia Risk05:15

Viral Transgene Expression in Rodent Hearts and the Assessment of Cardiac Arrhythmia Risk

Published on: July 27, 2022

2.1K
Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research06:51

Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research

Published on: October 20, 2023

1.6K

Related Concept Videos

Heart Valves01:16

Heart Valves

The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
11.9K
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
537
Anatomy of the Heart01:27

Anatomy of the Heart

The human heart is made up of three layers of tissue that are surrounded by the pericardium, a membrane that protects and confines the heart. The outermost layer, closest to the pericardium, is the epicardium. The pericardial cavity separates the pericardium from the epicardium. Beneath the epicardium is the myocardium, the middle layer, and the endocardium, the innermost layer. There are four chambers of the heart: the right atrium, the right ventricle, the left atrium, and the left ventricle.
119.7K
Introduction to z Scores01:06

Introduction to z Scores

A z score (or standardized value) is measured in units of the standard deviation. It tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
z scores...
11.2K
Introduction to z Scores01:05

Introduction to z Scores

A z score (or standardized value) is measured in units of the standard deviation. It indicates how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
z scores...
1.3K
z Scores and Area Under the Curve01:17

z Scores and Area Under the Curve

z scores are the standardized values obtained after converting a normal distribution into a standard normal distribution. A z score is measured in units of the standard deviation. The z score tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a z score of...
19.6K