Avoiding neurological complications

Led by Gianni Angelini and Umberto Benedetto

Neurological complications such as mini strokes and post-operative delirium are distressing to patients and, in the case of stroke, life-threatening with lifelong implications. Microemboli (small air or solid particles such as clots dislodged during surgery) in the cerebral circulation are associated with brain injury and are markers for stroke risk. Through our research on microemboli we aim to avoid and reduce neurological complications.

We aim to quantify microemboli in patients undergoing cardiac surgery using a technique called diffusion weighted MRI. Specifically, we study patients having coronary bypass surgery (CABG), aortic valve replacement (AVR) or trans-aortic valve implantation (TAVI). We then evaluate interventions designed to reduce the risk of stroke. This includes:

  • Investigating whether filling the pericardial space (around the heart) with CO2 can reduce microemboli during AVR surgery.
  • Evaluating outcomes for patients undergoing conventional AVR surgery (which is a more invasive type of surgery) against TAVI (which is minimally invasive). This will determine whether TAVI minimises microemboli, and therefore reduces the risk of neurological complications.
  • Investigating whether the use of protective devices (filter baskets or deflection shields) during surgery can minimise¬†microemboli.