Abstract
AIR EMBOLISM during cardiac surgery can result in neurologic and various other complications. The air usually enters the systemic circulation from 3 different sources: intravenous catheters, cardiopulmonary bypass (CPB) circuit, and/or the surgical field. Incomplete deairing is more likely in the presence of large hearts and in patients undergoing reoperative cardiac surgery because of difficulty in complete mobilization of the heart. Systemic air embolization after termination of CPB and reversal of anticoagulation is rare. A case of massive air embolism from a tear near the right superior pulmonary vein (RSPV) in a patient with pre-existing cardiomegaly after mitral valve replacement (MVR) is reported. Clinical management issues (re-establish CPB, initiate hypothermia, retrograde circulation, conservative management, etc) are discussed.
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