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March 1956

Ventricular Fibrillation in the Hypothermic State: III. The Management of Coronary Air Embolism and Ventricular Fibrillation

Author Affiliations

From the Department of Surgery, Indiana University School of Medicine.

AMA Arch Surg. 1956;72(3):502-507. doi:10.1001/archsurg.1956.01270210132021

The present study was undertaken in order to investigate two potential complications of open cardiac surgery in the hypothermic state—coronary air embolism and ventricular fibrillation. The latter is difficult to manage under any circumstances and especially under hypothermic conditions. It constitutes the single greatest hazard of open cardiac surgery during hypothermia. In moderately cooled, normal, control dogs ventricular fibrillation occurs regularly when venous inflow into the heart is shut off and a right ventriculotomy is performed.1 Air embolism to the coronary arteries constitutes a serious threat whenever an open left cardiotomy is performed or a right ventriculotomy is done in the presence of a ventricular septal defect. It is usually followed by ventricular fibrillation, especially during hypothermia.

MATERIALS AND METHODS  Healthy mongrel dogs were used. Anesthesia was induced by the intravenous administration of minimal amounts of thiopental sodium. Tracheal intubation was then carried out, and hyperventilation with oxygen was

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