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Retrograde Cerebral Perfusion for Treatment of Air Embolism After Valve Surgery

Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India

For reprint information contact: Vitthal Gadhinglajkar Shrinivas, MD Tel: 91 0471 244 3152 Fax: 91 0471 244 6433 Email: shri{at}sctimst.ker.nic.in Department of Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum – 695011, Kerala, India.

Air embolism occurred after termination of cardiopulmonary bypass in a 22-year-old man undergoing aortic valve replacement for rheumatic aortic insufficiency. Normothermic retrograde cerebral perfusion was instituted for 5 min at a flow rate of 300–500 mL·min^-1, maintaining internal jugular vein pressure < 25 mmHg. The aortic cannula was declamped intermittently for 5–10 seconds. Mean arterial pressure was kept at 60–70 mmHg. The patient recovered without any neurological deficit.