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Ann Thorac Surg 1975;20:418-423
© 1975 The Society of Thoracic Surgeons


Articles

Ventricular Fibrillation Without Left Ventricular Venting

Observations in Humans

Hans H.J. Zwart, M.D.*, Jerome Z. Brainard, B.S., Richard A. DeWall, M.D.

From the Department of Thoracic-Cardiovascular Surgery, Kettering Medical Center and the Cox Heart Institute, Kettering, Ohio.

* Address reprint requests to Dr. Zwart, Cox Heart Institute, 3525 Southern Blvd., Dayton, Ohio 45429

Pressures were measured in the heart and great vessels of 52 patients who underwent coronary revascularization. In 25 patients the left ventricle was vented during fibrillation; in the others a vent was not used. Samples for blood gas analysis were obtained twice during fibrillation from the aorta, left atrium, pulmonary artery, and right atrium. Left ventricular venting was found to be effective in keeping mean left heart pressures below 10 mm Hg, although temporary incompetence of the aortic valve or malfunction of the vent occasionally caused higher pressures. Vent use led to air embolism in the aorta in 16% of the patients.

In the nonvented patients mean left heart pressures remained between 10 and 20 mm Hg. However, higher values were frequently observed. Blood gas analysis demonstrated that without venting, retrograde pulmonary flow occurred during fibrillation. No abnormality was encountered that could be related to nonventing.




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