Expert: Ronald Levy, M.D. - 2/6/2010

Question
QUESTION: My mother in law just had open heart surgery - valve replacement- and now wont wake up. All her vitals are normal and cat scans show nothing. She responds to pain and pupils react. She moves legs and arms randomly, also have been doing EEG's and they tell us they are normal. She is 79 and in relatively good health, besides her leaky valves. It's been 6 days. Do you have any ideas? Docs say they just don't know and all of us are at a loss.

ANSWER: It's hard to say. It is NOT likely due to anesthesia. Most often it is due to microemboli in the brain. Particularly after aortic valve surgery. It is one of the inherent risks of the surgery. Have they done CAT scans or MRIs? It could be due to other causes as well (medications, etc). Most patients do recover most if not all previous function, so keep the faith.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Just did an MRI. It showed nothing. Can you tell me what microemboli is. Latest update shows everything is normal and she is healing well just won't wake. I know you cant diagnose but just searching for possible ideas. Thanks so much

Answer
Microemboli are small air bubbles or blood clots that are too small to see but can cause strokes. As I mentioned before, it is impossible to say why she hasn't woken but she is healing so hopefully, in time, she will wake up. I'm sure the doctors are exploring every avenue to figure out the reason.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston