[HSF] Embol-X

[hgrmd at aol.com]

Erdinc,
  I understand, but it's a shame.  You have to make the best of the situation.
Hal 
 
-----Original Message-----
From: enaseri at hotmail.com.tr
To: OpenHeart-L at lists.hsforum.com
Sent: Fri, 2 Mar 2007 3:39 PM
Subject: Re: [HSF] Embol-X


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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