One Stage Total Repair of the Aortic Arch Anomaly using the Regional Perfusion.
- Author:
Woo Sung JANG
1
;
Woong Han KIM
;
Cheong LIM
;
Hong Kook LIM
;
Sun Kyung MIN
;
Jae Kun KWAK
;
Eui Seuk CHUNG
;
Dong Jin KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Korea. woonghan@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Regional blood flow;
Aorta, arch;
Hypothermia;
Neurocognitive deficits
- MeSH:
Aorta;
Aorta, Thoracic*;
Brachiocephalic Trunk;
Brain;
Catheters;
Chorea;
Circulatory Arrest, Deep Hypothermia Induced;
Diagnosis;
Follow-Up Studies;
Heart Septal Defects, Ventricular;
Humans;
Hypoplastic Left Heart Syndrome;
Hypothermia;
Infant;
Infant, Newborn;
Mortality;
Perfusion*;
Regional Blood Flow;
Reoperation;
Scimitar Syndrome
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2006;39(6):434-439
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Deep hypothermic circulatory arrest during repair of aortic arch anomalies may induce neurological complications or myocardial injury. So we surveyed if the regional cerebral and myocardial perfusion might eliminate those potential side effects. MATERIAL AND METHOD: From March 2000 to December 2004, 62 neonates or infants with aortic arch anomaly underwent one stage biventricular repair using the regional perfusion technique by single surgeon. Preoperative diagnosis of the arch anomaly consisted of coarctation (n=46), interruption of the aorta (n=12), hypoplastic left heart syndrome (n=2) and truncus areteriosus (n=2). Combined anomalies were ventricular septal defect (n=51), TAPVR (n=1), PAPVR (n=1) and atrioventricular septal defect (n=2). Arterial cannula was inserted at the innominate artery. RESULT: The mean regional perfusion time of brain was 28+/-10 min. Operative mortality rates was 0 (0/62). Late death was 1 (1/62) during 11+/-7 months of follow-up. Neurologic complications consisted of transient chorea in 1 case. There was no reoperation associated with arch anolamy. Pulmonary complication associated with arch repair occurred in 1 case which was managed by aortopexy. CONCLUSION: One-stage arch repair using the regional prefusion is safe and effective in minimizing the neurologic and myocardial complications.
