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Retrograde cerebral perfusion and delayed hyperbaric oxygen for massive air embolism during cardiac surgery

^a Department of Surgery, University of California, San Francisco, San Francisco, USA
^b Department of Anesthesia, University of California, San Francisco, San Francisco, USA
^c Veterans Administration Medical Center, San Francisco, USA
^d Department of Hyperbaric Medicine, Saint Francis Memorial Hospital, San Francisco, USA

*Corresponding author. Assistant Professor of Surgery, UCSF, San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA. Tel.: +1 415-750-2102 (office); fax: +1 415-750-2181.

E-mail address: sloaneguy{at}gmail.com (T.S. Guy).

We report a case of massive air embolism from a ventricular vent line during cardiac surgery successfully treated with emergent retrograde cerebral perfusion and delayed hyperbaric oxygen therapy. The etiologies of this rare but potentially devastating complication are discussed along with prevention and treatment options.

Key Words: Gas embolism; Complications of cardiac surgery