[HSF] Embol-X

[Jean BACHET]

Dear Hal,

I totally agree with this technique even though I never stop CPB.. Having
the anaesthesiologist expanding completely the lungs  is also for me
mandatory.
Of course, I was not inferring in my previous post that Anis's patients had
not been correctly managed. I just wanted to point out that in most cases of
stroke, surgeons are prone to make atheromatous debris responsible for the
complication whereas many other causes are possible, and in particular, air
embolism.
And you certainly will agree with me that, when seeing (either on videos in
meetings or live in the operating rooms) some colleagues de-airing their
patients, you can legitimately be somewhat frightened for the poor innocent
chap on the table.

Jean.

----- Original Message ----- 
From: <Hgrmd at aol.com>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Thursday, March 01, 2007 8:20 PM
Subject: Re: [HSF] Embol-X


> 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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