Which of the following is the most sensitive to detect air bubbles at the termination of cardiopulmonary bypass (CPB)?
ExplanationD. Epiaortic echocardiography is the most sensitive and specific technique to detect air bubbles at the termination of CPB. De-airing is facilitated by head-down position, and venting before and during initial cardiac ejection, in addition to filling up the heart with vent in place. TEE is very useful in detecting pockets of air, especially within the left ventricle. But the risk of atheromatous emboli still persists and is worse in cases where aorta was manipulated extensively, cross-clamped numerous times and in percutaneous transcatheter aortic valve replacements. Newer devices with baskets to catch such emboli have proven to be very useful.
