Unexpected, transesophageal echocardiography-detected left ventricular microbubbles during off-pump coronary artery bypass graft surgery

Akhtar, Shuaib; Lluberes, Vincinio; Allen, Keith B.; Rajaii-Khorasani, Ahmad; Wasnick, John D.

doi:10.1053/jcan.2001.20362

Cited by 11 publications

(4 citation statements)

References 6 publications

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“…A BRIEF REVIEW OF RECENT LITERATURE demonstrates that gas embolism is known to occur in cardiac surgery, both on-pump from bypass circuit sources (8) and offpump (2). It happens in endoscopy (1), laparoscopic surgery (16), tissue biopsy (21), neurosurgery (30), liver transplantation (29), during central venous line insertion and removal (12), in orthopedic surgery (7), with laser surgery (20), during neuroangiography and cardiac catheterization procedures (26,34), in cardiac ablation procedures (17), and in arthroscopy (14).…”

mentioning

confidence: 99%

Microvascular gas embolization clearance following perfluorocarbon administration

Eckmann

Ломиворотов

2003

Journal of Applied Physiology

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Effective treatment of vascular gas embolism may be possible with emulsified fluorocarbon compounds. We tested the hypothesis that a fluorocarbon emulsion delivered before gas embolization would enhance bubble motion through the vasculature, favoring more rapid clearance. Air microbubbles were injected into the rat cremaster microcirculation in six groups of rats receiving Perftoran, an emulsified fluorocarbon, or saline immediately before, 2 h before, or after bubble injection. Embolism dimensions and dynamics were observed by using intravital microscopy. Surface area at lodging was equal between groups. Bubbles having smaller volume embolized smaller diameter vessels in the Perftoran pretreatment groups. A higher incidence of bubble dislodgement and larger distal displacement occurred in these two groups, with a 36% decrease in the time to bubble clearance and restoration of blood flow. Intravascular emulsified fluorocarbon administration before gas embolization affected initial bubble conformation, increased bubble dislodgement, and resulted in bubble displacement further into the periphery of the microcirculation. These dynamic events did not occur if embolization preceded fluorocarbon administration.

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mentioning

confidence: 99%

Microvascular gas embolization clearance following perfluorocarbon administration

Eckmann

Ломиворотов

2003

Journal of Applied Physiology

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“…However, there are other rare etiologies of false-positive PFO that may occur within three cardiac cycles. They include spontaneous gas formation caused by abrupt changes in atrial pressure following respiratory maneuver [52] and air crossing from the RA to the LA by means of Thebesian veins [53].…”

Section: Discussionmentioning

confidence: 99%

Air embolism during operative hysteroscopy: TEE-guided resuscitation

Sabsovich

Abel

Lee

et al. 2012

Journal of Clinical Anesthesia

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“…Therefore, CO 2 gas trapped in any part of circulation is not likely to cause systemic embolism due to bubbles. Proximal arterial sling may prevent proximal coronary artery system embolization but Akhtar and colleagues [6] showed that left ventricular air bubbles come from thebesian veins drained to the left ventricle. Thus, these bubbles may cause systemic embolization.…”

Section: Discussionmentioning

confidence: 99%

“…However, blowing of compressed air or oxygen into the coronary artery may cause embolic complications. Coronary artery embolism [5], left ventricular cavity air filling [6], massive pulmonary artery embolization during the repair of injured coronary vein [7] have been reported. Herein, we report a case of massive systemic air embolism during an OPCAB operation.…”

Section: Introductionmentioning

confidence: 99%

Massive systemic air embolism during off-pump coronary artery surgery

Kuralay

2009

European Journal of Cardio-Thoracic Surgery

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In OPCAB (off-pump coronary artery bypass) operations, development of cardiac arrest during the distal anastomosis to obtuse marginal coronary artery leads to significantly low blood pressure in the ascending aorta. Therefore, blowing of compressed air in high flow on not-slinged coronary artery may cause air mobilization from the coronary artery system into the ascending aorta that may result in severe brain damage.

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Unexpected, transesophageal echocardiography-detected left ventricular microbubbles during off-pump coronary artery bypass graft surgery

Cited by 11 publications

References 6 publications

Microvascular gas embolization clearance following perfluorocarbon administration

Microvascular gas embolization clearance following perfluorocarbon administration

Air embolism during operative hysteroscopy: TEE-guided resuscitation

Massive systemic air embolism during off-pump coronary artery surgery

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