The incidence of stroke after coronary artery bypass grafting (CABG) is around 1.3% in the Society of Thoracic Surgeons database but carries a mortality of almost 20% (1,2). The stroke rate is even higher with aortic valve replacements with the Determining Neurologic Outcomes from Valve Operations (DeNOVO) study reporting stroke rates as high as 17% (3). It is also likely that variations in definition of stroke leads to underreporting of this event. There is thus, no denying that stroke remains the Achilles heel of cardiac surgery and efforts must be made to mitigate its occurrence.