Significant hemodynamic change is rarely shown in the case of bypass surgery for infra-renal aortic aneurysm. However, a man underwent aortoiliac bypass surgery for dissecting infra-renal aortic aneurysm experienced sudden cardiac arrest and hypoxemia just after declamping of aorta and subsequent renal impairment. We supposed that transient myocardial dysfunction after declamping and release of inflammatory materials after reperfusion caused cardiac arrest and renal impairment. Therefore, careful anesthetic management is needed not only during the clamping of aorta but also at the time of declamping even in the infra-renal aortic bypass surgery.
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