Bubbles in the Heart

To the Editor: The image by Catapano et al1 gives misleading information concerning bubbles in the heart in patients with prosthetic valves. They speculated that “bright particles” seen in the left ventricular cavity are consistent with gas bubbles that occur in scuba divers after hypobaric decompression. We disagree with this speculation, because this phenomenon is well documented in patients with prosthetic valves. In their large series, Gencbay et al2 found a strong correlation between serum lactic dehydrogenase levels and quantity of bubbles. They suggested hemolysis as a cause of bubble formation. Moreover, Kaymaz …