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The Annals of Thoracic Surgery, Vol 55, 1467-1471, Copyright © 1993 by The Society of Thoracic Surgeons
K Orihashi, Y Matsuura, Y Hamanaka, T Sueda, H Shikata, S Hayashi and T Nomimura
Using transesophageal echocardiography during open heart operations, we
found another form of retained intracardiac air, "pooled air," in addition
to the form of "bubbles" that had been reported by other authors. The
pooled air was detected in all of 13 patients (100%); it was located at the
right upper pulmonary vein in 13 (100%), left ventricular apex in 9
(69.2%), left atrium in 8 (61.5%), right coronary sinus of Valsalva in 8
(61.5%), left atrial appendage in 4 (30.8%), and left upper pulmonary vein
in 3 (23.1%). The pooled air was found also in the pulmonary artery in 6 of
8 patients (75.0%) in whom the pulmonary artery was clearly visualized. In
1 patient, 5 mL of air was aspirated from the left ventricular apex,
followed by a reduced size of the air on the transesophageal
echocardiographic image. Because intracardiac air rapidly changes its
locations and appearances, continuous monitoring is important, especially
at weaning from bypass. The long-axis view of the heart is useful not only
for detecting and locating the air, but also for guiding and evaluating the
procedures to remove air.
ARTICLES
Retained intracardiac air in open heart operations examined by transesophageal echocardiography
First Department of Surgery, Hiroshima University School of Medicine, Japan.
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