Experimental Coronary Air Embolism. Assessment of Time Course of Myocardial Ischemia and the Protective Effect of Cardiopulmonary Bypass¹

Abstract

In 74 mongrel dogs 0.02 ml air/kg of body weight was injected into the left anterior descending coronary artery (LAD). Forty-three dogs were studied without (group I) and 31 with (group II) extracorporeal circulation (ECC). Time course and extent of myocardial ischemia were assessed by continous thermographic measurements as well as by fluorescence techniques. Coronary air embolism resulted in an immediate decrease of myocardial temperature associated with transmural ischemia. In 31 surviving dogs (72%) of group I this phenomenon was fully reversible within 8.7 minutes as compared with 5.4 minutes in 100% of the surviving dogs from group II. No postembolic death occurred in the group II animals. In group II the postembolic temperature decrease was significantly less than that in group I, and, in addition, the myocardial area involved was significantly smaller. The results indicate that the extent of myocardial ischemia following coronary air embolism and its time course can be well-documented by means of thermocardiography; using extracorporeal circulation survival can be improved and myocardial damage minimized.

Coronary air embolism during coronary angioplasty

“…The time course of events is consistent with findings of experimental air embolism [4]. Depending on the solubility of the gas, the bubbles will keep the arterioles occluded until they are reabsorbed or pushed into the coronary sinus IS].…”

Coronary air embolism: Incidence, severity, and suggested approaches to treatment

“…A close correlation was described in animal models. Injection of 0.02 ml/kg of air into the coronary arteries of dogs resulted in a 28% rate of mortality [9]. The surviving animals spontaneously recovered global heart function within 15 min.…”

Preparation of PCI Balloons: What Is the Best Method to Avoid Air in the Balloon? A Comparison of Different Methods of Connecting PCI Balloons and the Inflation Syringe while Removing Air from the Balloon

“…We did not approach this volume in our study. Another study with dogs showed a mortality rate of 28% in dogs after injection of 0.02 mL air/kg of body weight [14]. Other researchers demonstrated increasing cardiac depression in pigs by injecting air bubbles with approximate volumes of 0.002 mm 3 (diameter: 75 µm), 0.014 mm 3 (diameter: 150 µm) or 0.113 mm 3 (diameter: 300 µm) [12].…”