[HSF] Deairing the heart

[prasannasimha]

Having gone through various phases of teaching =- from being taught to 
being a teacher let me tell you one thing - when making residents do an 
ASD the one thing that I personally will do is deair even if everything 
else is done by the resident.
I have seen enough residents having significant air embolisms during 
their learning curve that I insist on deairing once after they have done so.
In fact GB Parulkar (our senior teacher in KEM) would come to just deair !!
Being cavalier about deairing can and will cause problems. Most learn 
through the lessons learnt from their teachers but remember many have 
learnt this after paying a biter price.
The original problems in CPB were often related directly to air 
embolism. See the articles by Gibbon, Clarence Dennis etc who realized 
that this was one of the most important steps (which now is considered 
routine). In fact  Melrose developed "cardioplegia" not for myocardial 
protection but to develop a method to prevent "air embolism"
Prasanna
Ani Anyanwu wrote:
> The numerous and highly variable views on this topic, to the extent of even discussing how to put a needle in the aorta to extract air best (I must confess I was stunned at the seriousness many attach to this), consolidate my view that most of what we do in this regard (deairing) is either, ill-understood, inconsequential or irrelevant. 
>
> My suspicion is that it doesn’t really matter what we do - so far as one gets the gross air out, the rest is fine talk. I know I will as usually incur the wrath of my seniors, but if it is so crucial and as technical as list members portray, how come we are getting so many highly opinionated but varying views? Surely they can't all be right at the same time? Maybe they can all be wrong though...Of course the red flag is that practically no contributor on this has provided evidence (experimental or clinical) to justify their deairing strategy - at the end of the day it is just surgeon preference, voodoo or a recipe handed by our teachers. I suspect whatever one chooses (apart from ignoring the air) works, not because of what we do, but because of the attempts we make (by whatever means) to remove the air.
>
> Ani
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