A new de-airing technique that reduces systemic microemboli during open surgery: a prospective controlled study

Area of Science:

• Cardiovascular Surgery
• Anesthesiology
• Thoracic Surgery

Background:

• Air embolism during cardiac surgery can cause severe complications, including ventricular dysfunction and neurologic deficits.
• Pulmonary veins are common sites for air emboli trapping.
• Effective de-airing is crucial for patient safety in open-heart procedures.

Purpose of the Study:

• To evaluate a new cardiac de-airing technique designed to minimize air entry into pulmonary veins.
• To assess the efficacy of staged cardiac filling and lung ventilation for flushing residual air.
• To compare the new technique against conventional methods in reducing air embolism.

Main Methods:

• Prospective enrollment of 20 patients undergoing elective open-heart surgery.
• Comparison between a new technique (open pleurae, staged perfusion/ventilation) and a conventional technique (closed pleurae, dead space ventilation).
• Continuous monitoring of air emboli using transesophageal echocardiography and transcranial Doppler.

Main Results:

• Significantly lower air embolism detected via echocardiography and transcranial Doppler in the new technique group (P < .001).
• Reduced microembolic signals observed in the study group post-cardiopulmonary bypass (P < .001).
• Shorter de-airing time in the new technique group (10 minutes vs. 17 minutes, P < .001).

Conclusions:

• The evaluated cardiac de-airing technique is simple, reproducible, controlled, safe, and effective.
• The method is cost-effective due to reduced de-airing time and no additional expenses.
• This technique offers a promising approach to mitigate air embolism risks in cardiac surgery.