Cerebral microbleed burden after aortic and cardiac surgery is associated with extracorporeal circulation exposure: Evidence from young patients with heritable connective tissue disorders
6 affiliations
- 1Programma Neuroimmagini Funzionali e Molecolari, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- 2Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
- 3Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
- 4UO Interaziendale Clinica Neurologica Metropolitana, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- 5Azienda Sanitaria Provinciale di Catania, P.O. “Castiglione-Prestianni”, Bronte, Catania, Italy
- 6IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
Abstract
Background and purpose:: Cerebral microbleeds (CMBs) occur after surgery involving extracorporeal circulation (ECC), though confounding risk factors may obscure this association. Patients with heritable connective tissue diseases (HCTDs) requiring early surgery provide an ideal model to investigate ECC-related CMBs. We aimed to assess CMB prevalence, distribution, and surgical correlates in a genetically confirmed HCTD population.
Methods:: We retrospectively analyzed 111 HCTD patients with brain magnetic resonance. CMBs number and location were correlated with clinical and surgical data, including procedure frequency, type, and, when available, ECC duration.
Results:: All 58 patients exposed to surgery under ECC exhibited CMBs, compared to only four surgery-naïve individuals. CMBs showed a predominantly lobar pattern. CMB burden was significantly higher in patients with multiple surgeries and longer ECC duration (p < 0.001), whereas valve type and surgical technique showed no association.
Discussion:: In our cohort, CMBs were identified in all individuals with ECC exposure. The absence of significant differences in CMB burden across surgical techniques weakens the hypothesis that CMBs originate solely from metallic microemboli. In young, normotensive patients with HCTDs, ECC exposure was uniformly associated with CMBs, with burden increasing with repeated procedures and ECC duration.
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BibTeX
@article{vornetti2026cerebral,
title = {{Cerebral microbleed burden after aortic and cardiac surgery is associated with extracorporeal circulation exposure: Evidence from young patients with heritable connective tissue disorders}},
author = {Gianfranco Vornetti and Riccardo Regazzo and Valentina Barone and Valentina Belacchi and Giuliana La Rosa and Elisabetta Mariucci and Andrea Donti and Caterina Tonon and Raffaele Lodi and Luca Spinardi},
journal = {Journal of Cerebral Blood Flow \& Metabolism},
year = {2026},
month = oct,
doi = {10.1177/0271678x261499072},
url = {https://doi.org/10.1177/0271678x261499072},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cerebral microbleed burden after aortic and cardiac surgery is associated with extracorporeal circulation exposure: Evidence from young patients with heritable connective tissue disorders
AU - Gianfranco Vornetti
AU - Riccardo Regazzo
AU - Valentina Barone
AU - Valentina Belacchi
AU - Giuliana La Rosa
AU - Elisabetta Mariucci
AU - Andrea Donti
AU - Caterina Tonon
AU - Raffaele Lodi
AU - Luca Spinardi
PY - 2026
DA - 2026/10/20
JO - Journal of Cerebral Blood Flow & Metabolism
DO - 10.1177/0271678x261499072
UR - https://doi.org/10.1177/0271678x261499072
AB - Background and purpose:: Cerebral microbleeds (CMBs) occur after surgery involving extracorporeal circulation (ECC), though confounding risk factors may obscure this association. Patients with heritable connective tissue diseases (HCTDs) requiring early surgery provide an ideal model to investigate ECC-related CMBs. We aimed to assess CMB prevalence, distribution, and surgical correlates in a genetically confirmed HCTD population. Methods:: We retrospectively analyzed 111 HCTD patients with brain magnetic resonance. CMBs number and location were correlated with clinical and surgical data, including procedure frequency, type, and, when available, ECC duration. Results:: All 58 patients exposed to surgery under ECC exhibited CMBs, compared to only four surgery-naïve individuals. CMBs showed a predominantly lobar pattern. CMB burden was significantly higher in patients with multiple surgeries and longer ECC duration (p < 0.001), whereas valve type and surgical technique showed no association. Discussion:: In our cohort, CMBs were identified in all individuals with ECC exposure. The absence of significant differences in CMB burden across surgical techniques weakens the hypothesis that CMBs originate solely from metallic microemboli. In young, normotensive patients with HCTDs, ECC exposure was uniformly associated with CMBs, with burden increasing with repeated procedures and ECC duration.
SN - 0271-678X
SN - 1559-7016
ER -