The Role of Nasopharyngeal Temperature Monitoring in Detection of a Malpositioned Superior Vena Cava Cannula in an Emergency Coronary Artery Bypass in a Patient With Ventricular Septal Defect

A 55 year-old woman was admitted to the CCU ward of our university hospital due to typical chest pain. The
patient received supportive care and was transferred to the operating room for an emergency repair of the ventricular
septal defect (VSD) and myocardial revascularization. The surgical team was notified regarding the
tolerance to cooling detected by the temperature monitoring and also, the congestion of eye and blanching of
forehead. After a few maneuvers, the cannula was repositioned. In a few seconds, the forehead was cooled,
while the airlocking episodes were lifted completely and the blanching and chemosis in the face and eyes all resolved.
The septal defect was approached through the left ventricle; a 15 in 20 mm foramen, due to the ischemic
rupture of the superior portion of the anteroseptal wall, was repaired with a patch of hemoshield. The incision
over the LV was then repaired with 2 parallel bands of felt. The patient was operated on and transferred to the
intensive care unit.