Blue toe syndrome following modified Bentall procedure: a case report

Azmi Özler, İbrahim Arif Tarhan, Tamer Kehlibar, Yücesin Arslan, Mehmet Yılmaz, Mert Dumantepe, Kazım Berköz

Department of Cardiovascular Surgery, Siyami Ersek Cardiovascular Surgery Center, İstanbul

Cholesterol crystal emboli syndrome, also named “blue toe syndrome” can be rarely seen following heart surgery and invasive cardiology procedures. A 64-year-old man was operated on for ascending aortic aneurysm and severe aortic regurgitation. On the third postoperative day he complained of his cold, pale toes with severe pain. Lower extremity arterial Doppler ultrasonography examination showed a triphasic flow pattern in all segments. Complaints of the patient increased on the following day and cyanosis began to be evident on the distal end of his toes. Oral anticoagulation therapy was continued because of the new aortic prosthesis, and clinical signs recovered spontaneously. The patient has had no ischemic symptoms in the last six months.

Keywords : Bentall procedure; blue toe syndrome; cholesterol crystal embolism

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