Persistent systemic air embolism and delayed pulmonary hemorrhage after weaning from cardiopulmonary bypass--a case report.

Systemic air embolism (SAE) occurring during cardiac surgery is usually associated with high morbidity and mortality. We present a fatal case of persistent SAE identified by transesophageal echocardiography (TEE) after weaning from cardiopulmonary bypass (CPB). Perplexities in identification of a bronchovascular fistula and hesitation in aggressive management to arrest the resultant continuous air entry into systemic circulation caused death as an aftermath. Related instances in literature have been reviewed and appropriate managements are herein discussed.