Work

Unexpectedly detected air bubbles in left ventricle during off-pump coronary artery bypass grafting: a case report

Year: 2024

Type: article

Abstract: Unlike on-pump beating coronary artery bypass grafting, off-pump coronary artery bypass grafting (OPCAB) rarely causes intracardiac air embolisms. However, there have been several reports of air embolisms that occurred during OPCAB using a CO 2 blower, which is commonly used to facilitate visualization of the anastomotic site. Herein, we describe a rare case of air bubbles detected only in the left ventricle during OPCAB. A 72-year-old man visited our hospital due to a myocardial infarction. Because of diffuse tight stenosis of the coronary artery, urgent OPCAB was performed under median sternotomy. After successful grafting, a significant number of air bubbles were detected in the left ventricle but not in the right side of the heart. To prevent air embolism, the patient was maintained in the Trendelenburg position. The surgery was completed, and no neurological abnormalities were observed during hospitalization. Air bubbles entered the left ventricle through a specific route. The use of an excessive flow rate of CO 2 blower should be avoided during anastomosis. This case and other similar incidents encourage maintaining vigilant monitoring for air bubbles using transoesophageal echocardiography, even during OPCAB.

Source: Journal of Cardiothoracic Surgery

DOI: 10.1186/s13019-024-03150-7

Authors: Youna Sim, Boohwi Hong, Sang jun Park, Man-Shik Shim

Institutions: Chungnam National University, Chungnam National University Hospital

Language: English

Topic: Cardiac and Coronary Surgery Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,790