Related Experiment Videos
Time course of high-intensity transient signals in patients undergoing elective heart valve replacement: a
A Lindner1, D Georgiadis, A Lühmann
1Department of Neurology, Martin-Luther-University Halle-Wittenberg, Germany.
Insights
High-intensity transient signals (HITS) significantly increase after heart valve replacement surgery, indicating the valve implant is the cause. Monitoring HITS is crucial for patient evaluation post-surgery.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Medical Imaging
Background:
- Elective heart valve replacement is a common procedure.
- Intracranial high-intensity transient signals (HITS) are a potential complication.
- Understanding the time course of HITS is important for patient management.
Purpose of the Study:
- To evaluate the time course of intracranial high-intensity transient signals (HITS).
- To assess HITS in patients undergoing elective heart valve replacement.
Main Methods:
- Serial transcranial Doppler monitoring was performed on 33 patients.
- Monitoring occurred before and at 1, 5, 90, and 180 days after surgery.
- Microembolic signals were identified using standard criteria.
Main Results:
- HITS prevalence rose from 3% preoperatively to 41% on postoperative day one.
- HITS prevalence remained stable throughout the postoperative period.
- Anticoagulation intensity and valve type did not affect HITS counts.
Conclusions:
- Heart valve implantation is definitively linked to HITS development.
- Valve type, duration, and anticoagulation intensity do not influence HITS.
- Bilateral monitoring is recommended for accurate HITS assessment.
Background And Aims Of The Study:
This study was performed to evaluate the time course of intracranial high-intensity transient signals (HITS) in patients undergoing elective heart valve replacement.
Methods:
Thirty-three patients were enrolled in this study. The examination protocol included serial (before and at one, five, 90 and 180 days after surgery) monitoring sessions with transcranial Doppler and detailed neurological examination. Monitoring was performed bilaterally over the middle cerebral arteries for one hour per session using 2 MHz probes. Microembolic signals were recognized according to standard criteria and stored on a computer for later evaluation.
Results:
HITS prevalence increased from 3% preoperatively to 41% on the first postoperative day and remained unchanged during the postoperative period. No influence of the intensity of anticoagulation or valve type on HITS counts was evident. Unilateral monitoring provided adequate results in 83.9% of cases.
Conclusions:
The causative role of the valve implant in the pathogenesis of HITS appears certain, since their prevalence dramatically increases following valve implantation. Valve type, duration of valve implant or intensity of anticoagulation did not influence HITS counts. Bilateral monitoring is warranted for accurate evaluation of HITS counts in this patient group.