OBJECTIVE Intracardiac beating-heart procedures require the introduction and exchange of complex instruments and devices. To prevent potential complications such as air embolism and bleeding, a universal cardioport was designed and tested. METHODS The design consists of a port body and a series of interchangeable sleeves. The port uses a fluid purging system to remove air from the instrument ...

Vascular accidents involving the spinal cord, in contrast to the brain, are extremely rare. Damage to the spinal cord from verified emboli seems to be an even greater rarity and no examples were found by Blackwood (1958) in a series of 3,737 postmortem reports from the National Hospital, Queen Square, London. Embolic myelomalacia has been reported in bacterial endocarditis and other forms of he...

BACKGROUND While clinically symptomatic cerebral air embolism secondary to neuro-angiographic procedures is rare, the incidence in a large series of procedures is unknown. Understanding this complication's frequency and etiology is critical if systems are to be instituted to reduce its incidence. METHODS We prospectively reviewed 4,568 consecutive neuro-angiographic procedures performed betwe...

We have known since the 17th century that emboli can cause stroke but, despite their occasional visualisation in the retinal circulation, a diagnosis of embolic stroke is usually one of “guilt by association,” which is made by the detection of an appropriate embolic source in a patient with stroke. Frequently, .1 potential embolic source exists; determining which is clinically relevant may be i...

Gaseous microemboli (GME) are known to be delivered to the arterial circulation of patients during cardiopulmonary bypass (CPB). An increased number of GME delivered during adult CPB has been associated with brain injury and postoperative cognitive dysfunction. The GME load in children exposed to CPB and its consequences are not well characterized. We sought to establish a baseline of arterial ...

The purpose of this study was to develop an animal model that could be used to test the ability of Doppler ultrasound to detect arterial emboli composed of materials that are often involved in cerebral emboli. Emboli introduced into the rabbit aorta via the left renal artery consisted of clotted whole blood, platelets, atheromatous material, fat, or air. The ultrasound examination was carried o...

Neuropsychological impairment is a very common complication of cardiopulmonary bypass (CPB). The principal cause of postoperative cognitive impairment is thought to be cerebral microemboli during CPB. We recently investigated the effects of perfusionist interventions and aortic cannulation techniques on cerebral emboli production during coronary bypass (CABG) surgery. Patients undergoing isolat...

The transport of long gas bubbles, suspended in liquid, through symmetric bifurcations, is investigated experimentally and theoretically as a model of cardiovascular gas bubble transport in air embolism and gas embolotherapy. The relevant dimensionless parameters in the models match the corresponding values for arteries and arterioles. The effects of roll angle (the angle the plane of the bifur...

The risk of air emboli is a concern for all perfusionists. A new clamping device for use with centrifugal pumps is designed to clamp both the arterial and venous lines at the first indication of air or retrograde flow, thereby allowing the perfusionist to evaluate the situation and correct the problem before entraining air into the arterial pump head. After evaluating this device in our lab, we...

Cardiopulmonary bypass (CPB) may introduce microemboli into the patient's arterial circulation. These may arise from the CPB circuit. Most relevant studies have been performed in vitro; there are relatively few clinical studies. We used the Emboli Detection and Classification quantifier (EDAC) (Luna Innovations, Roanoke, VA) in a prospective clinical audit of emboli in a contemporary CPB circui...