AW: [HSF] Deairing the heart

[Hgrmd at aol.com]

Ani,
  Like I said before, a lot of what we hope is effective may take many  years 
before it is conclusively demonstrated.  That is why I always make  sure the 
bubbles are gone prior to removing the needle vent.  The only  downside is 
that it takes a few minutes longer.  I am considered to be a  "fast surgeon", but 
I will take all day, if necessary, to get the best job done  for my patient.
  I am certainly not naive in thinking I get every last bubble, as  your 
anesthesiologists demonstrate by bubbles in the descending aorta.   However, that 
doesn't negate my efforts to scavenge what I can.  BTW, all  of those deairing 
rituals I was trained to do, I largely abandoned when I began  using TEE to 
guide air removal.  Many times with the use of CO2, no  maneuvers are necessary 
at all.  Other times, it takes half an hour of  jiggling the heart and 
manually inflating the lungs.
Hal
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