Published 7 August 2008, doi:10.1136/bmj.a992
Cite this as: BMJ 2008;337:a992

Filler

Occluded circulation

Jules Dussek, retired cardiothoracic surgeon, Sevenoaks

jules.vanessa.dussek@btinternet.com

The first 150 words of the full text of this article appear below.

Thirty years ago my boss had told me of an aortic valve replacement he had performed. The heart came off bypass well with a good output, but later it was apparent that, although the patient’s legs were warm to the touch, there was no pulsatile flow. "It was as if," he said, "there was a sponge in the aorta." And then the penny dropped. During the operation, it was customary to put a sponge in the left ventricular cavity to prevent calcium from the valve getting into the heart. This sponge in those days did not appear on the swab count, and it had not been removed after the valve replacement. At laparotomy the embolic sponge was removed, and a healthy flow restored to the legs.

I am now a retired cardiothoracic surgeon and have thus spent most of my life dealing with human pumps, valves, tubes, leaks, and blockages, . . . [Full text of this article]


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