POOLED AIR IN OPEN-HEART OPERATIONS EXAMINED BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Background. The clinical significance of pooled air detected by transe sophageal echocardiography during open heart operations is not clear. Methods. Thirty-eight consecutive patients undergoing an open heart op eration or an operation on the ascending aorta were divided into two g roups on the basis of the absence (group 1, n = 14) or presence (group 2, n = 24) of pooled air. They were examined for intramyocardial echo contrast, ST segment elevation, conduction disturbances, and regional wall motion abnormalities. Results. Echo contrast was found in no pat ient in group 1 and 66.7% of group 2 patients (p < 0.001). New regiona l wall motion abnormalities were detected in no patient in group 1 ver sus 33.3% of group 2 patients (p < 0.05), and ST segment elevation was seen in 33.3% of group 2 patients versus no group 1 patients (p < 0.0 5). Intramyocardial echo contrast was newly detected after the appeara nce of pooled air more frequently in patients with ST segment elevatio n (p < 0.001). Atrioventricular block and sinus arrest appeared in 3 p atients and 2 patients, respectively. Postoperative regional wall moti on abnormalities were found in 25.0% of patients and were not closely related to intraoperative echo contrast findings. Conclusions. Pooled air, which is often detected in open heart operation by means of trans esophageal echocardiography, is related to several cardiac events, inc luding ST segment elevation, conduction disturbances, and regional wal l motion abnormalities, although most of these are transient.