Introduction
The incidence of symptomatic cerebral infarction after minimally
invasive cardiac surgery (MICS) was higher than that after median
sternotomy because of the retrograde blood flow from the femoral artery1. However, as MICS techniques are more widely used,
the incidence of symptomatic brain infarction due to retrograde
perfusion via the femoral artery has decreased. Recent studies have
shown that the incidence was similar to that after median sternotomy2. In Japan, the incidence rate of stroke after MICS
is reported as 1.0% 3. At our institution, the
incidence of symptomatic cerebral infarction after MICS was
zero4.
The significance of symptomatic cerebral infarction after cardiac
surgery has been discussed in some studies, and some reports showed that
silent brain infarction (SBI) also poses a risk of postoperative
delirium 5. In addition, some studies have indicated
that it may accelerate the development of vascular dementia6, which is an important clinical factor that can
affect quality of life. The incidence rates of SBI are 29% after median
sternotomy 5 and 29% after coronary angiography and
stenting 7. This result indicates that the incidence
of SBI is not low. However, no previous report has provided detailed
information about SBI after MICS with retrograde perfusion via femoral
cannulation.
In this study, the detailed characteristics of SBI after MICS were
evaluated on head magnetic resonance imaging (MRI).