AW: [HSF] Deairing the heart

[prasannasimha]

And How ?
Prasanna

Dr. Roberto Battellini wrote:
> Prasanna,
> Do you know how did the first Starr valve patient die?
> Ask Bob!
> Roberto
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha
> Gesendet: Mittwoch, 7. März 2007 15:09
> An: OpenHeart-L at lists.hsforum.com
> Betreff: Re: [HSF] Deairing the heart
>
> 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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