[HSF] Embol-X

[Hgrmd at aol.com]

Dear Dr. Bachet,
  Like you, I've been concerned about the air balls seen on TEE during  live 
surgery.  I've sometimes been off CPB 15-20 minutes before I remove  the 
needle vent in the root.  If you are worried about tying a pressurized  aorta, 
simply transiently drain blood from the venous line until the pressure is  at a 
level you can comfortably tie. 
  Interestingly, I've found that air balls are essentially  eliminated in the 
minithoracotomy cases where CO2 is continuously infused  into the closed 
chest.  When I visited Fred Mohr's program a couple of  years ago, I noticed that 
he doesn't even vent the root in his MIC  mitrals.  Any potential air is 
removed by the LV vent.  The only  potential source of nitrogen in such cases is 
careless introduction of air  bubbles when doing the saline test of the repair.  
My experience has been  similar to his.  This eliminates the stress of tying 
the aortic root vent  stitch through a tiny incision.
Hal
<BR><BR><BR>**************************************<BR> AOL now offers free 
email to everyone.  Find out more about what's free from AOL at 
http://www.aol.com.