AW: [HSF] Deairing the heart

[prasannasimha]

As you are aware mine is mixed adult/pediatric with both coronary and 
valvular adult work.
I use an epicardial echo when doing repairs or whenever I can get hold 
of it in other cases. For routine CABG cases and congenital/valve we do 
not do deairing routinely with epicardial/ TEE monitoring simply because 
we do not have enough probes/machines. (I have to compete with the cath 
lab for the Echo machine  when doing repairs and for some time I had a 
horrible Sonosite mini machine -Chand will remember me using that !! 
when all the larger transport permitted machines were being repaired. 
Luckily I am able to get hold of a HP/ Phillips Sonos 2500 now.
I do not think we have a higher stroke rate etc.
One thing is that we routinely screen all CABG patients for their 
carotids as a routine policy.
When I used to use TEE - when we got the new probe I compared the 
deairing after a classical deairing drill and then looked at TEE and 
frankly did not find much difference  if a good classical deairing drill 
is used.
Prasanna
ICHFNO at aol.com wrote:
> I would like to pose the following question as I am not sure how many  
> pediatric surgeons are still involved in HSF. How many peds surgeons use CO2 for  
> thier intracardiac repairs? Most, if not all of the places where we provide ped  
> cardiac surgery do not have CO2. Peds cardiac surgery is for the most part  
> intra-cardiac surgery. Also a number of places where we operate also do not 
> have  TEE. So for all our intra-cardiac repairs we do not use CO2 and in the vast 
>  majority we do not have TEE to assess remnant bubbles. Last year our  
> post-operative stroke rate was 1/317 in pump cases. By the way our kids don't  have 
> atheroma's for the most part and few if any of the aortic valve or mitral  
> valve procedures we perform have calcified leaflets.
>  
> Bill  
>
> William M  Novick MD
> Paul Nemir Jr., MD Professor
> International Child Health and  Surgery
> University of Tennessee Health Sciences Center
> Founder and Medical  Director
> International Children's Heart  Foundation
>
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