Thorac Cardiovasc Surg 2010; 58(1): 17-22
DOI: 10.1055/s-0029-1186242
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Minimizing Circulatory Arrest by Using Antegrade Cerebral Perfusion for Aortic Arch Reconstruction in Infants Causes Fewer Postoperative Adverse Events

J. Selder1 , S. Algra1 , F. Evens1 , M. Freund2 , J. Strengers2 , T. Schouten3 , F. Haas1
  • 1Cardio Thoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands
  • 2Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
  • 3Anesthesiology, University Medical Center Utrecht, Utrecht, Netherlands
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Publikationsverlauf

received April 26, 2009

Publikationsdatum:
13. Januar 2010 (online)

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Abstract

Background: Because deep hypothermic circulatory arrest (DHCA) carries a risk for neurological damage, antegrade cerebral perfusion (ACP) is used increasingly for aortic arch surgery in infants. We assessed the short-term effects of minimal DHCA (< 30 minutes) versus prolonged DHCA (> 30 minutes) during biventricular aortic arch reconstruction. Methods: Twenty-six infants (< 3 months of age) who had undergone aortic arch reconstruction were retrospectively analyzed: 15 infants without DHCA (group A) and 11 infants with DHCA (group B). Group B was further divided into < 30 minutes DHCA (group B1, n = 6), and ≥ 30 minutes DHCA (group B2, n = 5). Additionally, minimal DHCA (group A + B1) was compared to prolonged DHCA (group B2). Results: In the minimal DHCA group (A + B1), 29 % of the patients had a postoperative adverse event, compared to 80 % in the prolonged DHCA group (B2) (p < 0.05). Average length of stay in hospital was 25 days shorter for the minimal DHCA group (15 days versus 40 days, p < 0.01).

Conclusion: Minimal DHCA results in fewer adverse events and a reduced length of stay, compared with prolonged DHCA. Therefore, during aortic arch surgery in infants, DHCA should be minimized by using antegrade cerebral perfusion.

References

MD, MSc Jasper Selder

Cardio Thoracic Surgery
University Medical Center Utrecht

Lundlaan 6

3584 EA Utrecht

Netherlands

eMail: jappe@jappe.net