Surgical causes

- Heart surgery using ECC is the main cause of AGE. This affects mainly the carotids, particularly the right carotid artery. Although the incidence was traditionally estimated at around 0.1 to 0.3%, endovascular bubble migration appears to be much more frequent now that more precise methods of detection are used. It approaches 50 to 60% by Doppler velocimetry73. Valve replacement surgery involves greater risk than coronary surgery. Three causal situations have been identified: a de-airing or gas leak in the ECC circuit; air entering an open and badly flushed cavity and - during systolic contraction - being suddenly ejected into the arterial system; and lastly oxygen gas bubble formation in blood during too rapid warming up procedures74,75.

- Vascular surgery, particularly on the thoracic aorta or on the carotid.

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