Catastrophic Carbon Dioxide Gas Embolism During Endoscopic Vein Harvesting for Coronary Artery Bypass Graft Surgery

While more commonly described in laparoscopic surgery1, a carbon dioxide (CO2) embolism during endoscopic vein harvesting (EVH) is a rare event during cardiac surgery. While EVH typically has a good safety profile, a CO2 embolus can have catastrophic outcomes, including cardiac arrest.1, 2 Transesophageal echocardiography (TEE) can be instrumental for detection and is more sensitive than other monitors such as end-tidal carbon dioxide (EtCO2) or pulmonary artery (PA) pressure changes.1 We present a case in which TEE revealed a catastrophic CO2 embolism during coronary artery bypass graft surgery.