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Pulmonary artery dissection was observed in a 64-yr-old female patient with severe pulmonary hypertension, which was probably primary (pulmonary vascular resistance, 817 dyn.s.cm-5; normal range less than or equal to 200 dyn.s.cm-5). The patient was admitted to the hospital because of severe dyspnea on exertion. Echocardiography demonstrated a dissecting aneurysm of the pulmonary artery. Right heart catheterization revealed severe pulmonary hypertension (mean pulmonary artery pressure, 64 mm Hg; normal range, 10 to 22 mm Hg); dissection of the pulmonary artery was confirmed by pulmonary arteriography. One-year follow-up was uneventful. In the literature, 28 patients with dissecting aneurysm of the pulmonary artery are reviewed. The dissection has only been diagnosed in life in one patient (by echocardiography).

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Haemodynamic changes after intracoronary air embolism (0,02 ml/kg air in the left coronary artery) were studied in 16 dogs. The air was introduced in 8 animals during cardiopulmonary bypass and in 8 animals without bypass. In both groups the air embolization caused acute ischemia with myocardial necrosis. Immediately after the injection the anterior wall became akinetic; 24 hours after injection CPK increased to more than 800 U. One half of the animals without cardiopulmonary bypass died during acute ischemia due to refractory arrhythmias; there was no mortality in the group with cardiopulmonary bypass. The left ventricular damage due to air embolization cannot be significantly reduced with cardiopulmonary bypass; the bypass only helps to "tide over" the animal during the period of acute ischemia.