The past eight years have witnessed significant advances in the field of open-heart surgery and extracorporal circulation. Operative mortality has declined and postoperative survival time has lengthened.
Sad experience with other iatragenic disease indicates, however, that it would be too much to expect that an intervention as drastic as open-heart surgery should be without its own peculiar complication. Such things as fragmentation of prosthetic valve balls with embolization, hemosiderosis due to traumatic destruction of red blood cells by the prosthesis, occasional cases of endocarditis on prosthetic valves, and endocardial fibroelastosis apparently due to hemodynamic alterations induced by valvular prostheses have been reported occasionally, not to mention effects on the lung and risk of hepatitis.
The most common anatomic complication of open-heart surgery, however, appears to be a peculiar type of hemorrhagic necrosis which extensively affects the subendocardium of the left ventricle. First described by Morales et al,1 and subsequently