Simple active air evacuation procedure for right ventricular failure caused by intracoronary air embolism

In cardiac surgical cases such as valve replacement, right ventricular failure caused by intracoronary air embolism sometimes occurs after aortic declamping and during weaning from cardiopulmonary bypass (CPB). The details are reported of a de-airing method which involves simply rotating the arterial cannula towards the base of the heart, with no need for a particular circuit. This method was used in ten patients who, following open-heart surgery, suffered postoperative right ventricular failure due to air embolism in the right coronary artery that did not respond to other de-airing methods. The technique resolved the problem in all patients, who were quickly weaned from CPB and ultimately discharged. Rotation of the arterial cannula may represent a simple means of resuscitating patients who have suffered right ventricular dysfunction that is unrelieved by other, conventional methods.