Visualising myocardial injury after noncardiac surgery: a case series using postoperative cardiovascular MRI

Abstract

Myocardial injury after noncardiac surgery (MINS) and perioperative myocardial injury are associated with increased morbidity and mortality. Both are diagnosed by a perioperative increase in troponin, yet there is controversy if MINS is a genuine myocardial insult. We applied postoperative cardiovascular magnetic resonance T2 mapping techniques to visualise acute myocardial injury (i.e. oedema) in six patients with multiple cardiovascular risk factors who underwent aortic surgery. The burden of myocardial oedema was substantially higher in four patients with elevated troponin qualifying for MINS, compared with patients without MINS. The data and images suggest that MINS represents genuine myocardial injury.

Keywords: MINS; T2 mapping; cardiovascular magnetic resonance; myocardial injury after noncardiac surgery; myocardial oedema; perioperative myocardial injury.