Complete neurological recovery after delayed onset resuscitation in a normothermic witnessed arrest

Cardiac arrest following aortic dissection carries high morbidity and mortality, primarily due to poor neurological outcomes. Most efforts are directed towards perfusing vital organs and replenishing oxygen and adenosine triphosphate (ATP) stores during and immediately after arrest. Methods of reperfusion (including external cardiopulmonary resuscitation (CPR), open CPR, extracorporeal life support and ventricular assist devices) and other ATP preservation methods, such as pharmaceutical agents and hypothermia, are maximally beneficial only if started early during cardiac arrest. We describe a case of aortic rupture with arrest on the table which was re-perfused after 20 minutes, using cardiopulmonary bypass (CPB), but still managed to recover without neurological sequelae.