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Eur J Cardiothorac Surg 2001;19:96-98
© 2001 Elsevier Science NL

Case report

Cholesterol crystal embolization after cardiac operations.

Report of two cases

^a Thoracic and Cardiovascular Surgery, Universitätsklinikum RWTH Aachen, Germany
^b Institute of Pathology, Universitätsklinikum RWTH Aachen, Germany

Received 27 June 2000; received in revised form 9 October 2000; accepted 3 November 2000.

Corresponding author. Klinik für Thorax, Herz und Gefäßchirurgie, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany Tel.: +49-241-8089-961, fax: +49-241-8888-454
e-mail: jvazquez-jimenez{at}post.klinikum.rwth-aachen.de

We report two cases of systemic cholesterol embolization after coronary bypass surgery under extracorporeal circulation. First clinical symptoms starting at 48–72 h after cardiac operation were severe abdominal pain and elevated ischemia associated blood parameters. In both patients a laparotomy was performed but fatal outcome due to multi-organ failure could not be avoided. The awareness of this often fatal complication is of great importance for the surgeon since prevention is the only effective treatment.

Key Words: Cholesterol emboli syndrome • Multiple cholesterol emboli syndrome • Cholesterol clefts • Cutaneous emboli • Blue toe syndrome • Cardiac surgery complications

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