Systemic hyperkalemia for cardiac arrest on CPB with or without cross-clamping

Myocardial protection may be compromised in situations with a patent left internal mammary artery (LIMA) graft or an unclamped aorta. Because of collateral coronary blood flow, electrical arrest may not be achieved. Currently, hypothermia is often used to augment myocardial protection and provide cardiac arrest in these situations. We report a simple, novel technique of systemic hyperkalemia during cardiopulmonary bypass to achieve rapid and complete electromechanical arrest. By providing complete diastolic arrest, uniform myocardial protection is ensured.