To reduce the neurological complications of deep hypothermic circulatory arrest, continuous cerebral perfusion was introduced, either by direct innominate artery cannulation or by a tubular prosthesis. This second option, used in our clinical experience, has been extended to applications other than aortic arch reconstruction, to facilitate cardiopulmonary bypass in small neonates (< 3.0 kg) with complex congenital heart defects, and to facilitate postoperative extracorporeal membrane oxygenation.
Get full access to this article
View all access options for this article.
References
1.
NewburgerJWJonasRAWernovskyGWypijDHickeyPRKubanKC. A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart surgery. N Engl J Med1993; 329: 1057–64.
2.
AsouTKadoHImotoYShiokawaYTominagaRKawachiY. Selective cerebral perfusion technique during aortic arch repair in neonates. Ann Thorac Surg1996; 61: 1546–8.
3.
McElhinneyDBReddyVMSilvermanNHHanleyFL. Modified Damus-Kaye-Stansel procedure for single ventricle, subaortic stenosis, and arch obstruction in neonates and infants: midterm results and techniques for avoiding circulatory arrest. J Thorac Cardiovasc Surg1997; 114: 718–26.
4.
TchervenkovCIKorkolaSJShum-TimDCalaritisCLaliberteEReyesTU. Neonatal aortic arch reconstruction avoiding circulatory arrest and direct arch vessel cannulation. Ann Thorac Surg2001; 72: 1615–20.
5.
TakedaYAsouTYamamotoNOharaKYoshimuraHOkamotoH. Arch reconstruction without circulatory arrest in neonates. Asian Cardiovasc Thorac Ann2005; 13: 337–40.
