Acute ischemic brain lesions in infective endocarditis: incidence, related factors, and postoperative outcome

  • Okazaki S
  • Yoshioka D
  • Sakaguchi M
 et al. 
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BACKGROUND: Acute brain infarction affects the timing and regimen of cardiac surgery in patients with infective endocarditis (IE). We aimed to identify preoperative brain MRI characteristics, incidence, and related factors for acute ischemic lesions in left-sided IE patients undergoing cardiac surgery. Furthermore, we investigated whether preoperative acute ischemic lesions are associated with postoperative neurological complications in IE patients.METHODS: We retrospectively reviewed consecutive patients with a definite left-sided IE who underwent cardiac surgery in 6 university-affiliated hospitals from January 2004 to November 2011. Preoperative brain MRI evaluations were systematically performed on all patients without contraindications, regardless of neurological complications, with the aim of preventing perioperative complications. Patients were included if diffusion-weighted imaging and fluid-attenuated inversion recovery sequences were performed within 14 days after diagnosis. Associations between acute ischemic lesions and related factors were analyzed. Neurological complications within 30 days after surgery were evaluated for postoperative outcome analyses.RESULTS: Of 139 consecutive patients with left-sided IE who underwent cardiac surgery, 85 patients were evaluated in this study. The mean age was 58 + 16 years, and 22 patients (26%) were women. Preoperative MRI revealed acute ischemic lesions in 47 patients (55%), and 19 of these patients developed neurological symptoms. Among the patients with ischemic lesions, 24 (60%) had small lesions (

Author-supplied keywords

  • Acute Disease
  • Adult
  • Aged
  • Asymptomatic Diseases
  • Brain Ischemia
  • Brain Ischemia: diagnosis
  • Brain Ischemia: epidemiology
  • Brain Ischemia: surgery
  • Cardiac Surgical Procedures
  • Cardiac Surgical Procedures: adverse effects
  • Cerebral Infarction
  • Cerebral Infarction: diagnosis
  • Cerebral Infarction: epidemiology
  • Diffusion Magnetic Resonance Imaging
  • Endocarditis, Bacterial
  • Endocarditis, Bacterial: diagnosis
  • Endocarditis, Bacterial: epidemiology
  • Endocarditis, Bacterial: surgery
  • Female
  • Hospitals, University
  • Humans
  • Incidence
  • Japan
  • Japan: epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome

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  • S Okazaki

  • D Yoshioka

  • M Sakaguchi

  • Y Sawa

  • H Mochizuki

  • K Kitagawa

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