The Annals of thoracic surgery
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Although fortunately rare, the serious and potentially fatal complication of air embolism continues to occur following open-heart surgery. Its reliable prevention is dependent on the avoidance of specific procedural hazards and the exercise of various maneuvers to evacuate residual air from the heart before it is allowed to eject. Specifically, the beating heart should not be opened without ventricular fibrillation, cardioplegia, or aortic cross-clamping unless special precautions are exercised.