We report a case of a 5-year-old girl who suffered a massive arterial air e
mbolism during surgical closure of an atrial septal defect. The risk of per
manent neurologic deficits or even fatal outcome is significant (mortality
rate, 31%). We successfully treated a proven arterial air embolism with int
raoperative (retrograde cerebral perfusion) combined with postoperative pro
cedures (deep barbiturate anesthesia and hyperbaric oxygenation). At discha
rge the girl had fully recovered from the initial neurologic defects.