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Ann Thorac Surg 2008;85:978-981. doi:10.1016/j.athoracsur.2007.12.067
© 2008 The Society of Thoracic Surgeons
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Original Articles: Cardiovascular

Characterization of Lipid Particles in Shed Mediastinal Blood

Atli Eyjolfsson, MDa, Sara Sciclunaa, Per Johnsson, MD, PhDa, Filip Petersson, PhDb, Henrik Jönsson, MD, PhDa,*

a Department of Cardiothoracic Surgery, Center for Heart and Lung Disease, Lund University Hospital, Lund, Sweden
b Department of Electrical Measurements, Faculty of Engineering, LTH, Lund University, Lund, Sweden

Accepted for publication December 26, 2007.

* Address correspondence to Dr Jönsson, Department of Cardiothoracic Surgery, Lund University Hospital, SE-221 85 Lund, Sweden (Email: henrik.jonsson{at}med.lu.se).

Background: Shed mediastinal blood is known to be a source of microemboli in cardiac surgery. The aim of this study was to characterize in detail the lipid particles found in this blood.

Methods: Blood samples were collected from 24 patients undergoing routine cardiac surgery with cardiopulmonary bypass. Arterial and shed blood was analyzed using the Coulter counter technique to establish the number and size of particles. The composition of these lipid particles was compared with that of adipose tissue from the mediastinum using gas chromatography. Scanning electron microscopy was used to visualize the lipid particles in samples of shed blood.

Results: Lipid particles in the size range of 10 to 60 µm were characterized in shed mediastinal blood, and more than 300,000 particles per milliliter of blood were found. Triglyceride profiles in these lipid particles and in adipose tissue were similar, suggesting that their origin is the mediastinum. Scanning electron microscopy showed spherical formations corresponding in size to the particles counted using the Coulter counter.

Conclusions: During the past decade attention has focused on microembolism in cardiac surgery, and this study has helped define the problem. Different strategies, such as eliminating the use of shed mediastinal blood or purifying the blood by different techniques, may improve the results of cardiac surgery in the future.




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H. Jonsson, A. Eyjolfsson, S. Scicluna, P. Paulsson, and P. Johnsson
Circulating particles during cardiac surgery
Interactive CardioVascular and Thoracic Surgery, May 1, 2009; 8(5): 538 - 542.
[Abstract] [Full Text] [PDF]


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