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The Annals of Thoracic Surgery, Vol 32, 604-608, Copyright © 1981 by The Society of Thoracic Surgeons

ARTICLES

Massive arterial air embolism due to rupture of pulsatile assist device: successful treatment in the hyperbaric chamber

L Tomatis, M Nemiroff, M Riahi, J Visser, E Visser, A Davies, D Helentjaris, F Stockinger, D Kanten, M Oosterheert, A Valk and D Blietz

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.