Surgeon requested a target temperature of 28c after ep (electrophysiology study) mapping.There was concern for the right sided nirs (near-infrared spectroscopy) which were 62 with a left sided nirs of 78.Surgeon elected to cool to 18c.Four hours on bypass, apparent fibrin formation was noted in the oxygenator bundle/arterial filter area.The venous filter and the cardiotomy filter both appeared to have clot propagating higher in their respective areas.A teg (thromboelastography) was sent (which eventually resulted as hypocoagulable).The decision was made to change the entire circuit out under circulatory arrest.This was done in three minutes with the left nirs going from 94 to 92 and the right nirs going from 89 to 82.The oxygenator device was a terumo fx 15-30 with lot# yk03.Possible fibrin formation in bypass circuit oxygenator, possibly after arterial filter.It is unclear if this is a patient related issue or an equipment issue.
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