[HSF] Embol-X

[Hgrmd at aol.com]

Dear Dr. Bachet,
  Using TEE for air removal from the left side of the heart has been a  
standard part of my routine for close to 10 years, yet I know of some surgeons  who 
still do not routinely use it on AVR's!  Knowing Ani and his program,  I'm 
sure TEE-monitored removal of air was done on those 2 unfortunate  cases.
  To completely remove air on open cases, I take the patient  completely off 
pump for a few minutes prior to removing the aortic needle  vent.  The 
anesthesiologist then hand ventilates to completely expand the  lungs. This is an 
important maneuver in assuring that all the air from the  pulmonary veins has 
been removed.  While the patient is on CPB, the blood  flow through the veins is 
always subnormal.
 
Hal
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