title: An unusual iatrogenic cause of right coronary air embolism.
abstract: A 62-year-old woman undergoing redo mitral valve replacement was noted to have persistent intracardiac air following standard deairing procedures. Transesophageal echocardiography (TEE) identified air bubbles entering the left atrium from the right superior pulmonary vein. Exploration of the pleural cavity revealed a fistula between the pulmonary parenchyma and the right superior pulmonary vein caused by the atriotomy closure suture transfixing the edge of the lung, which was repaired with immediate disappearance of the air emboli. This demonstrates that transesophageal echocardiography is an invaluable aid to ensuring complete deairing after open heart procedures.
authors.affiliation: Department of Cardiac Surgery, Royal Victoria Hospital, Belfast, Northern Ireland.
authors.forename: R C
authors.initials: RC
authors.lastname: Baker
authors.forename: A N
authors.initials: AN
authors.lastname: Graham
authors.forename: A S
authors.initials: AS
authors.lastname: Phillips
authors.forename: G
authors.initials: G
authors.lastname: Campalani
mesh_terms: D000714:Anastomosis, Surgical; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D016156:Respiratory Tract Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery