[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
October 3, 1966

Postoperative Myocardial Necrosis May Begin in the Operating Room

JAMA. 1966;198(1):A41-A42. doi:10.1001/jama.1966.03110140017004

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Low cardiac output following open heart surgery often may be due to focal myocardial necrosis, say investigators at Henry Ford Hospital, Detroit.

Compromise of the smaller coronary vessels by microthrombi, microemboli and particulate foreign matter appears to be a major etiological factor.

Possible agents, said Azorides R. Morales, MD, associate in pathology, may include platelet aggregates, air emboli that escape into the coronary circulation during operation, the silicone antifoam used during extracorporeal circulation, and calcified emboli shed by the diseased heart valves.

Dr. Morales told the annual meeting of the American Society of Clinical Pathologists that necrotic lesions seen in patients with low output syndrome following heart surgery differ somewhat from those occurring in myocardial infarction following arteriosclerotic or thrombotic coronary artery occlusion.

The lesions occur in the absence of occlusion, or any significant degree of sclerosis, of the major coronary arteries. They are patchy and irregular in distribution,