Cholesterol emboli in cerebral arteries as a complication of retrograde aortic perfusion during cardiac surgery

A 57-year-old man developed severe neurological abnormalities following cardiac surgery. Postmortem examination showed cholesterol emboli in the distal branches of the major cerebral arteries, producing multiple cerebral infarcts, together with similar emboli in other organs. The findings indicate that retrograde aortic perfusion during the operation had dislodged atheromatous fragments which then were carried as emboli by the perfusion current. Recognition of this possible complication of retrograde aortic perfusion in elderly patients is emphasized.