Massive Coronary Air Embolism Treated Successfully by Simple Aspiration by Guiding Catheter.

Coronary air embolism remains a recognized complication of coronary catheterization despite a strong emphasis on prevention. It is almost always iatrogenic. It occurs mostly when catheters used for vascular procedures have not been adequately aspirated and flushed. Current treatment consists of supportive measures with 100% oxygen and analgesia and use of aspiration catheter. Here we report a case of massive coronary air embolism of left anterior descending artery and left circumflex artery because of loose Y-adapter connection during percutaneous coronary intervention. Patient suddenly developed hypotension, chest pain, ST elevation and finally asystole. Simple vigorous aspiration was done through guiding catheter restoring the flow and finally successful intervention. Thus simple aspiration can also do the wonder as bail-out measures in the standard treatment of air embolism.