Based on the literature data, the discussion covers the causes, preventive measures, and treatment of massive arterial air embolism, which is one of the most dangerous complications of artificial circulation (AC). Cerebral retroperfusion, hyperbaric oxygenation, low-temperature AC, and long-term administration of antihypoxic agents in the postoperative period have been considered most effective in the management of air embolism. The authors present their experience of successful management of four massive arterial air embolism cases, which is 0.22 percent of AC-assisted operations performed since 1984. Combined retrograde cerebral reperfusion and hypothermic AC have been used in the cases under discussion. Since it is impossible to determine the extent of embolism-associated brain damage and the limits of reliability of the applied therapy, it is essential in each embolism case to make use of all therapeutic means that are available in the given situation to combat this grave complication.

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