Atheroemboli complicating the pre- and postoperative course of aortocoronary bypass (the trash heart): case report with comment.

A fatal instance of myocardial atheroembolization is described. Analysis suggests two and perhaps three separate episodes of embolization: the first occurred spontaneously about 2 weeks before admission, the second occurred intraoperatively, and it is possible that a third occurred immediately postoperatively. Intraoperative manipulations were additive to the earlier episode of spontaneous embolization. The descriptive terminology, "trash heart," is suggested. Operative techniques to prevent embolization are discussed.