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Ann Thorac Surg 1999;68:575-576
© 1999 The Society of Thoracic Surgeons

Case Reports

An unusual iatrogenic cause of right coronary air embolism

Robert C. Baker, FRCSa, Alastair N.J. Graham, FRCSa, Anne S. Phillips, MDb, Gianfranco Campalani, MDa

a Cardiac Surgery, Royal Victoria Hospital, Belfast, Ireland
b Anesthesia, Royal Victoria Hospital, Belfast>, Ireland

Address reprint requests to Dr Campalani, Department of Cardiac Surgery, Royal Victoria Hospital, Grosvenor Rd, Belfast BT12 6BA, Northern Ireland
e-mail: gianfranco.campalani{at}general.rght.n-i.nhs.uk

A 62-year-old woman undergoing redo mitral valve replacement was noted to have persistent intracardiac air following standard deairing procedures. Transesophageal echocardiography (TEE) identified air bubbles entering the left atrium from the right superior pulmonary vein. Exploration of the pleural cavity revealed a fistula between the pulmonary parenchyma and the right superior pulmonary vein caused by the atriotomy closure suture transfixing the edge of the lung, which was repaired with immediate disappearance of the air emboli. This demonstrates that transesophageal echocardiography is an invaluable aid to ensuring complete deairing after open heart procedures.




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