Use of deep hypothermic circulatory arrest following ventricular laceration: a case report

Deep hypothermic circulatory arrest (DHCA) is usually a planned approach to certain types of cardiovascular surgery. This case report is an example of DHCA used to provide cerebral protection for a patient whose right ventricle was lacerated by an oscillating saw during sternotomy. The surgical case was a redo coronary artery bypass graft surgery. Anesthetic intervention with specific drug administration and steps taken for neuroprotection are discussed. Before DHCA, anesthetic interventions are used to reduce brain metabolism and, thus, oxygen consumption for the 30- to 60-minute window of complete circulatory arrest. Although not having an electroencephalographic monitor for the case, an interesting finding was that the bispectral monitor (or BIS monitor) was at the zero level for the entire circulatory arrest and about 30 minutes after rewarming.