Right-Sided Air Embolism after Cardiopulmonary Bypass: Not Only a Left Side Problem

Transesophageal Echocardiography (TEE) is extremely important for detecting intracardiac air. We present two cases of air embolism identified in the pulmonary artery and right ventricle, after valvular surgery associated with right atrial opening. We analyzed the high sensitivity of TEE for an early diagnosis and the need for continuous monitoring during the Cardiopulmonary Bypass (CPB), because intracardiac air rapidly changes its location and appearance. We evaluated the incidence and procedures for eliminating intracardiac air. We emphasize that not only the left side of the heart should be analyzed, also to look for achieving a complete deaeration in the right heart cavities, especially if the right atrium was opened.