[HSF] Embol-X

[erdinç naseri]

hal,
ı would die to have a permenant TEE in the operation room.For the time I 
have to live without it.
Erdinc
PS:TEE in the hospital operated by cardiologist who are too busy to do 
intraop TEE and no curious anesthesiology guy in this field.


>From: hgrmd at aol.com
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] Embol-X
>Date: Fri, 02 Mar 2007 14:14:36 -0500
>
>Erdinc,
>   Sounds like a good protocol, but TEE guidance is best.
>Hal
>
>-----Original Message-----
>From: enaseri at hotmail.com.tr
>To: OpenHeart-L at lists.hsforum.com
>Sent: Fri, 2 Mar 2007 8:09 AM
>Subject: Re: [HSF] Embol-X
>
>
>We have noticed that sometimes after the intracardiac operations( 
>valve,congenital,...) even after 30 minutes of aortic root venting there 
>are air bubles coming out of the LV.Here is our weaning and decanulation 
>protocol.
>1.Ventilating the lungs in increasing increments while warming.
>2.gentle manual massage and lifting of the heart from pericardial sac.
>3.Termination of CPB
>4.Taking out venous canulae and continue venting from aortic needle.(return 
>the vented blood through aortic canulae)
>5.Remove vent needle.
>6.Give protamine.
>7.carefully inspect aortic cannulae for several minutes.( small bubles 
>always come to the canulae)
>8.If large amount of air is present deair thruogh luer lock of the cannulae 
>and inspect for several more minutes)
>9.Aortic decanulation
>Erdinc
>
> >From: Hgrmd at aol.com
> >Reply-To: OpenHeart-L at lists.hsforum.com
> >To: OpenHeart-L at lists.hsforum.com
> >Subject: Re: [HSF] Embol-X
> >Date: Fri, 2 Mar 2007 07:05:12 EST
> >
> >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
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