Inui K, Orita H, Shimanuki T, Fukasawa M, Gotou S, Nakamura C, Washio M
Second Department of Surgery, Yamagata University School of Medicine, Japan.
Kyobu Geka. 1993 May;46(5):419-22.
We experienced a case of saphenous vein air embolism after coronary artery bypass graft, in which case we used vent catheter kept in the left atrium. Though it was considered that air bubbles were never aspirated through vent catheter, we speculated that the origin of air bubbles must be the vent catheter. And we made an experiment on the motion of air in the vent catheter using a model of left heart composed with soft reserver (atrium) and pulsatile pump (ventricle). When the pulsatile pump was arrest, the air bubbles were never aspirated from the vent catheter to the soft reserver even if we vented with strong negative pressure. But, when the pulsatile pump was in motion and the left atrium was vented with some negative pressure, some leaks of air bubbles were recognized. So we must pay much more attention to the degree of venting when the heart is in motion. Sometimes we use overpressure safety valve composed with vent catheter, but measured left atrial pressure showed that decreased left atrial pressure was only 2 mmHg. So its use should be restricted in the patients with good ventricular function.
我们遇到了一例冠状动脉搭桥术后大隐静脉空气栓塞的病例，在此病例中我们使用了置于左心房的排气导管。尽管认为从未通过排气导管抽出气泡，但我们推测气泡的来源一定是排气导管。我们使用由柔软储液器（心房）和搏动泵（心室）组成的左心模型对排气导管内空气的运动进行了实验。当搏动泵停止时，即使我们用强负压排气，气泡也不会从排气导管被抽入柔软储液器。但是，当搏动泵运动且左心房用一定负压排气时，会发现有一些气泡泄漏。所以当心脏运动时我们必须更加注意排气程度。有时我们使用与排气导管组成的超压安全阀，但测得的左心房压力显示左心房压力仅降低了2 mmHg。所以其使用应限于心室功能良好的患者。
