title: Massive arterial air embolism due to rupture of pulsatile assist device: successful treatment in the hyperbaric chamber.
abstract: We present the case of a patient who had rupture of a pulsatile assist device (PAD) accompanied by massive air embolism, and the treatment that brought it to a successful outcome. After rupture of the skin of the PAD balloon, a massive amount of air was injected into the ascending aorta. The patient was placed in Trendelenburg position and cooled in deep hypothermia with cardiopulmonary bypass. He was given 1 gm of methylprednisolone intravenously, and the aortic valve replacement and double vein bypass graft were performed. After completion of the operation, the patient was partially rewarmed to 30 degrees C central temperature and transported by ambulance to a hyperbaric chamber where he was compressed to 6 atmospheres absolute 9 hours after the accident with clinical signs of severe brain dysfunction. The patient recovered completely and was discharged from the hospital on the tenth postoperative day.
mesh_terms: D001243:Assisted Circulation / Q000009:adverse effects*; D004618:Embolism, Air / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007036:Hypothermia, Induced; D007431:Intraoperative Complications; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010106:Oxygenators / Q000009:adverse effects*; D011187:Posture
chemical_list: D008775:Methylprednisolone