The risk of central nervous system injury is very high after operation for the following reasons: the brain is at hypoperfusion level for a long time during the process of cardiac surgery under CPB; partial microembolus
forms; inflammatory response is hyperactive; and the range of temperature variation is large.6 The incidence of postoperative neurological complications for such patients can reach 2.3-9.6%.7 POCD after cardiac surgery with CPB is considered to be the main manifestation of intraoperative brain damage.
Single CTC or circulating tumour microembolus
(CTM) were identified on the basis of previously reported cytopathological criteria for malignancy .
To find out the source of microembolus
, the high-resolution MRI (HRMRI) of cervical artery was performed four days later; however, no typical appearance of dissection or atherosclerotic plaque was found [Figure 1]e and [Figure 1]f.
To prevent false assignment of a mitotic CTC as a microembolus
, CTM were defined as groups of cells containing 2 or more distinct nuclei.
The most acknowledged hypothesis is that VO originates from an infected microembolus
in the arterial system which becomes lodged in one of the metaphyseal arteries; this results in infarction and subsequent haematogenous spread of the infection.
Nowicki et al., "The application of ultrasonic methods to flow measurement and detection of microembolus
in heart prostheses," Acta Physica Polonica A, vol.