Cerebral Disorders after Open-Heart Operations

The hazard of arterial air embolism has been reduced by refinement of oxygenators but air emboli remain a threat, usually from trapping of air in the left ventricle at the termination of the operative procedure, despite careful evacuation and replacement with absorbable gases.

Abstract

ALTHOUGH development of the extracorporeal pump oxygenator has permitted rapid advances in cardiac surgery it has exposed the central nervous system to injury from a variety of agents despite the use of hypothermia to decrease its metabolic demands. The hazard of arterial air embolism has been reduced by refinement of oxygenators,1 2 3 4 but air emboli remain a threat, usually from trapping of air in the left ventricle at the termination of the operative procedure, despite careful evacuation and replacement with absorbable gases.5,6 Improperly designed coronary-suction devices may also be a source of air embolism.7 Embolization of silicone material from antifoam . . .