Following full rewarming, the patient is weaned from cardiopulmonary bypass. The inferior vena cava cannula is removed. The heparin is reversed with protamine. Diagnostic pressures of the aortic root and the superior vena cava are performed. Pulse oximetry is followed.
Transesophageal echocardiography is performed.
The pump blood is slowly returned to the patient. The aortic cannula is removed. Hemostasis and sternal closure is performed. This is done to decrease cerebral venous pressure and hence increase cerebral perfusion pressure. This is of particular importance when coming of cardiopulmonary bypass, at which time there may be relative systemic hypotension in the presence of elevated central venous pressure.