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J Thorac Cardiovasc Surg 2005;130:936-937
© 2005 The American Association for Thoracic Surgery

Brief Communication

Sudden cardiac arrest after coronary artery bypass grafting as a result of massive carbon dioxide embolism

Division of Cardiothoracic Surgery, The Brody School of Medicine, East Carolina University, Greenville, NC.

Received for publication February 9, 2005; revisions received April 30, 2005; accepted for publication May 3, 2005.

^_* Address for reprints: Alan P. Kypson, MD, FACS, Division of Cardiothoracic Surgery, The Brody School of Medicine–Room 252, East Carolina University, 600 Moye Blvd, Greenville, NC 27834 (Email: kypsona@mail.ecu.edu).

The first 20% of the full text of this article appears below.

Cardiogenic shock is a rare but potentially fatal complication of cardiac surgery. Numerous causes can lead to this outcome. Massive gaseous embolism leading to cardiac death is a rare but potential complication of endoscopic saphenous vein harvesting (EVH). ^1,2 A case of direct entry of carbon dioxide into the venous system of a patient undergoing EVH during coronary artery bypass grafting (CABG), resulting in hemodynamic collapse, is described.

Clinical Summary

A 43-year-old woman with no past medical history was seen with unstable angina. Nuclear stress testing revealed scintigraphic and electrocardiographic abnormalities in the anterior and lateral walls suggestive of left main disease. Catheterization demonstrated left main coronary artery spasm of 90%, relieved with intracoronary nitroglycerin to 30%. Despite calcium-channel blockers and nitrates, the patient continued to have symptoms, and a repeated stress test had positive results. The patient was referred to surgery.

CABG was performed with a vein graft to the left anterior descending and circumflex coronary arteries. Arterial . . . [Full Text of this Article]

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