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Case Reports
. 2017 Jul;44(1):14-18.
doi: 10.1007/s11239-017-1509-x.

Circulating microaggregates during cardiac surgery precedes postoperative stroke

Zühre Uz  1 , Dan M J Milstein  2 , Can Ince  1 , Bastian A J M de Mol  3
Affiliations
Case Reports

Circulating microaggregates during cardiac surgery precedes postoperative stroke

Zühre Uz et al. J Thromb Thrombolysis. 2017 Jul.

Abstract

Postoperative stroke and encephalopathy are potentially serious complications associated with coronary artery bypass grafting. In this case report a 78-year-old male patient receiving routine elective cardiac surgery presented with microaggregations in the sublingual microcirculation while on cardiopulmonary bypass that was undetected by routine intraoperative anticoagulation assessment. Microaggregates identified using video microscopy on his sublingual microcirculation during the procedure preceded a stroke postoperatively. Postoperative cerebral and carotid artery examination with computed tomography scanning revealed a left watershed cerebral infarct with carotid stenosis. This report presents intraoperative microcirculation-based evidence suggesting that observations of microaggregations, otherwise undetected by conventional anticoagulation assessment techniques, could serve as an early warning in elderly patients at high risk for postoperative cerebrovascular events.

Keywords: Cardiac surgery; Cardiopulmonary bypass; Microaggregates; Microcirculation; Stroke.

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