Coronary air embolism: A case report and review of the literature

Abstract

Coronary air embolism is a complication in the catheterization laboratory that can be associated with high morbidity and even mortality. A case report of air embolism and methods to prevent this complication from occurring are presented along with various management techniques.

Air embolism: an unusual cause of delayed death following gunshot wound to the chest

“…2,8,14 Administration of 0.02 mL/kg of gas into the coronary arteries in a dog model was associated with a mortality rate of 28%, and it has been estimated that for an embolus to pass through capillaries of 6 mm diameter a blood pressure of 200 mmHg is required. 6 In the reported case there was no injury to major vessels or significant blood loss, with the victim appearing initially stable. Problems arose however due to lung parenchymal damage from passage of the two projectiles close to the chest cavity, with injuries arising from the same mechanisms as in explosions where significant energy transfer derives from shock waves.…”

Beware of positive pressure: coronary artery air embolism following percutaneous lung biopsy

“…analysis yielded simplified approach with recommendations for flat, supine positioning for all SAE [6]. Additional treatment options to consider include hyperbaric oxygen by increasing dissolved O 2 deliver to tissues, pharmacologic coronary vasodilatation, direct percutaneous and/or endovascular aspiration of air from the aorta, or coronaries, or emergent cardiac bypass [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15].…”

Management of percutaneous coronary intervention complications

“…Air embolisation is a rare complication, reported in 0.1%–0.3% of cases, due to failure to clear air from the injection manifold system, and can be associated with significant haemodynamic compromise and death 5. Guide catheters should always be aspirated prior to connection to the pressure line.…”