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Ann Thorac Surg 2001;71:1369-1371
© 2001 The Society of Thoracic Surgeons

Case report

Venoarterial air embolus: a complication of vacuum-assisted venous drainage

Richard M. Davila, CCPa, Thomas Rawles, CCPa, Michael J. Mack, MDa

a Cardiopulmonary Research Science Technology Institute, Dallas, Texas, USA

Accepted for publication May 18, 2000.

Address reprint requests to Dr Mack, COR Specialty Associates of North Texas, P.A., 7777 Forest Ln, Suite A-323, Dallas, TX 75230
e-mail: mmack{at}crsti.org

Minimal access techniques with cardiopulmonary bypass use smaller cannula systems for management of cardiopulmonary bypass. To augment flow rates through the smaller cannula, the technique of vacuum-assisted venous drainage has been used. We describe a complication of vacuum-assisted venous drainage by inadvertent positive pressurization of the venous circuit resulting in a paradoxic air embolus across a patent atrial septal defect. Hazards of the current cardiopulmonary bypass systems and techniques for avoiding this potential complication are discussed.




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