Intracardiac Air Formed During Open Heart Surgery Evaluated by Intraoperative Transesophageal Echocardiography

By using transesophageal intraoperative echocardiography (ITEE) we investigated, the location and occurrence ratio of intracardiac air during open heart surgery and formatian of microbubbles during cardiopulmonary bypass. For this purpose, we divided patients who were planned to have elective open heart surgery into two groups. Group one was formed by 10 patients with aortic and/or mitral valve surgery, group two by 10 patients with coronary bypass surgery by cardiopulmonary bypass. Intracardiac air bubbles were detected in all patients in group one and half of patients in group two. By ITEE it was demonstrated that in 70% of group one patients, intracardiac air originated from pulmonary veins. Deairing procedures in the guidence of ITEE was not always successful in removing all the air but the intensity of bubbles was diminished. Carefully performed standard dearing methods could not provide removal of air bubbles in the pulmonary veins. No neurologic complications were observed. Using ITEE during deairing procedures will raise the attention to intracardiac air problems and will aid in preventing air embolism.