The Annals of thoracic surgery
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Two patients experienced an episode of massive air embolism during extracorporeal circulation. Several emergency measures were taken. (1) The roller pump was reversed to take out air from the aorta. (2) The circuit was disconnected and recirculated to eliminate air bubbles. (3) Perfusion was restarted and the patient cooled to 24 degrees C for 40 minutes. (4) Pentothal (thiopental), steroids, and assisted ventilation were administered. The outcome was favorable in both patients, and there were no neurological sequelae. Immediate cooling and prolonged circulation seem to be a satisfactory approach to this problem.
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We present the case of a patient who had rupture of a pulsatile assist device (PAD) accompanied by massive air embolism, and the treatment that brought it to a successful outcome. After rupture of the skin of the PAD balloon, a massive amount of air was injected into the ascending aorta. ⋯ After completion of the operation, the patient was partially rewarmed to 30 degrees C central temperature and transported by ambulance to a hyperbaric chamber where he was compressed to 6 atmospheres absolute 9 hours after the accident with clinical signs of severe brain dysfunction. The patient recovered completely and was discharged from the hospital on the tenth postoperative day.