Good day, so I was curious about this after watching a heart transplant surgery. Normally speaking, the cardiovascular system can be considered as a closed loop system where fluids that leak out don’t introduce air bubbles into the blood stream. However, when transplanting an organ, say a heart, from a donor to a recipient, there are multiple instances where there might be a risk of introducing air bubbles to the blood stream either when being connected to an artificial blood pump or sewing the new organ in.
My question is, how is it that they manage to remove air bubbles from a patients blood stream after completing a heart transplant?
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During the procedure, the surgeon places a cannula in the aorta, and two in the vena cava (SVC & IVC) and snares them so all the blood flow is diverted to the pump, and the patient is placed on cardiopulmonary bypass. The aorta is clamped below the aortic cannula, and then the old heart can be removed. The patients full blood flow is going through the bypass machine, so the heart and lungs are no longer contributing to the body. When a new heart is connected, an aortic root vent is placed, which helps to pull air out. Then the snares on the vena cava cannulas are released so some blood can fill the heart and allow the air to release through the aortic root vent. The patient is placed in trendellenburg so that any remaining bubbles will hopefully go down instead of up to the brain, and the cross clamp is released. Basically it’s a complicated answer but there are ways to vent the heart so the bubbles come out before the cross clamp is removed.
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