AW: [HSF] Deairing the heart

[Dr. Roberto Battellini]

Hal,
I agree that the only way to get absolutely all the air is to nearly stop
the arterial line and continue sucking from the needle vent under TEE.
The hidden bubbles in the pulmonary veins and muscular trabeculae come out
to the surface. 
Even that, 10 days ago I got a ventricular fibrillation in a patient (air,
for sure) after a Bentall when we took her  from the OP table to the bed.
Successfully defibrillated, she was awake the same day.
We also use Co2, may be one has to use intracardiac Co2? (we use it
intrapericardial)
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Hgrmd at aol.com
Gesendet: Donnerstag, 1. März 2007 20:21
An: OpenHeart-L at lists.hsforum.com
Betreff: 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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