Massive air embolism during interventional laser therapy of the liver: successful resuscitation without chest compression.

We report on a rare, acute, life-threatening complication during percutaneous thermal therapy for hepatic metastases. Massive cardiac air embolism occurred during a maneuver of deep inspiration after the dislodgment of an introducer sheath into a hepatic vein. The subsequent cardiac arrest was treated successfully by immediate transthoracic evacuation of the air by needle aspiration followed by electrical defibrillation. In procedures that may be complicated by gas embolism, cardiopulmonary resuscitation should not be initiated before considering the likelihood of air embolism, and eventually aspiration of the gas.