A case of perioperative cardiac arrest during reconstructive surgery for oral floor carcinoma

We report on a case of perioperative cardiac arrest during reconstructive surgery for cT4aN2cM0 oral floor carcinoma. The patient was a 74-year-old man without any complications. Preoperative laboratory test data, chest radiographs, and electrocardiogram showed no remarkable findings. We performed pull-through dissection with mandibular segmental resection and bilateral neck dissection. We planned the reconstruction at the fibula flap and the pectoralis major myocutaneous flap until the patient developed cardiac arrest during the surgery. With cooperation from other hospital departments, we were able to recover his heartbeat and maintain circulation by using percutaneous cardiopulmonary support (PCPS) and intra-aortic balloon pump (IABP). We modified our plan to reconstruct at only the pectoralis major myocutaneous flap. He did not develop cardiac arrest again and recovered without any sequela such as brain dysfunction. After postoperative rehabilitation, he was able to receive semisolid food orally.