Abstract
We experienced a case of cardiac arrest in a 78-year-old man during total gastrectomy. He was diagnosed with hypertension, diabetes mellitus and premature ventricular constriction, and medicated with β-blocker and calcium channel blocker. Anesthesia was maintained with oxygen -nitrous oxide-isoflurane and epidural block. Upon expos-ing the peritoneal region, heart rate suddenly decreased to 30 bpm and 3 rd degree A-V block was observed. One minute after the onset of bradycardia, cardiac arrest occurred, and percutaneous cardiopulmonary support (PCPS) was started 30 min after cardiac arrest. Coronary angiography showed a right coronary artery spasm. Intracoronary injection of nitroglycerin relieved the spasm and heart beat was acquired. Reexploration for intraab-dominal bleeding and splenotomy for rupture of the spleen, respectively, caused by cardiac massage were performed under PCPS. The patient regained conciousness 8 hr after cardiac arrest, and exhibited no neurological complications. We concluded that PCPS with heparin coated artificial lung and cannulas was effective for advanced life support for cardiac arrest occurring during operation.
