Cerebrovascular myocardium-tissue embolism: a rare complication of heart surgery: autopsy case report

Cardiovascular surgery is often associated with significant mortality ranging from 3% to 6%, and complications labeled as cerebral are identified as a cause of death in about 3%-9% of heart surgery associated mortality, including cerebrovascular embolism. With regards to heart surgery patients, neurologic complications are caused by arterial embolism predominantly associated with left-sided infective endocarditis. In this paper, we would like to present an unusual autopsy finding of cellular-myocardial embolism in the middle cerebral artery in a patient after acute mitral valve repair, coronary artery bypass graft, and maze procedure with left atrium appendage occlusion. The mechanism of embolism related with open heart surgery that we propose to underlie our case finding is “myocardial tissue embolism” with hemispheric encephalomalacia leading to death, which to date has not yet been described in the literature.