HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yoshikatsu Saiki Koichi Tabayashi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yoshioka, I. Articles by Tabayashi, K. Search for Related Content PubMed Articles by Yoshioka, I. Articles by Tabayashi, K. Related Collections Mediastinum Cardiac - other Pericardium

J Thorac Cardiovasc Surg 2009;137:957-962
© 2009 The American Association for Thoracic Surgery

Evolving Technology

Tagged cine magnetic resonance imaging with a finite element model can predict the severity of retrosternal adhesions prior to redo cardiac surgery

^a Department of Cardiovascular Surgery, Graduate School of Engineering, Tohoku University, Sendai, Japan
^b Department of Radiology, Graduate School of Engineering, Tohoku University, Sendai, Japan
^c Department of Bioengineering and Robotics, Graduate School of Engineering, Tohoku University, Sendai, Japan

Received for publication May 9, 2008; revisions received September 15, 2008; accepted for publication October 27, 2008.

^_* Address for reprints: Yoshikatsu Saiki, MD, PhD, Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574 Japan. (Email: ysaiki{at}mail.tains.tohoku.ac.jp).

Objective: Reoperative median sternotomy entails a risk of damaging the heart or great vessels. If the severity of retrosternal adhesion is accurately assessed before sternal re-entry, resternotomy-related complications can be prevented. The purpose of this investigation was to evaluate whether the severity of retrosternal adhesions can be accurately predicted by tagged cine magnetic resonance imaging.

Methods: Thirteen patients who were scheduled to undergo cardiac reoperation were investigated by electrocardiography-gated tagged cine magnetic resonance imaging before sternal re-entry. With the imaging data, the severity of retrosternal adhesion was scored visually on the basis of abnormality in regional myocardial motion and discordance in the tagged signals of the sternum and the myocardium. Also, with the aid of a finite element model, strain at the surface of the right ventricle was calculated on the basis of displacement of the tags on the heart over the cardiac cycle. For comparison, the adhesion severity was scored visually at the time of redo surgery by surgeons who were blinded to the preoperative assessment.

Results: The preoperative adhesion severity score, as determined visually by tagged cine magnetic resonance imaging, was correlated with the intraoperative severity score (correlation coefficient: r = 0.76, P < .01). Mean strain at the surface of the heart, as calculated preoperatively by finite element model analysis, was inversely correlated with the intraoperative adhesion severity score (r = –0.78, P < .01).

Conclusion: Tagged cine magnetic resonance imaging with a finite element model can provide an accurate quantitative assessment of retrosternal adhesions before redo cardiac surgery.

This article has been cited by other articles:

				T. Nagasao, M. Noguchi, J. Miyamoto, H. Jiang, W. Ding, Y. Shimizu, and K. Kishi Dynamic effects of the Nuss procedure on the spine in asymmetric pectus excavatum J. Thorac. Cardiovasc. Surg., December 1, 2010; 140(6): 1294 - 1299.e1. [Abstract] [Full Text] [PDF]

				T. Nagaso, J. Miyamoto, K. Kokaji, R. Yozu, H. Jiang, H. Jin, and T. Tamaki Double-bar application decreases postoperative pain after the Nuss procedure J. Thorac. Cardiovasc. Surg., July 1, 2010; 140(1): 39 - 44. [Abstract] [Full Text] [PDF]