scholarly journals Total circulatory arrest as a support modality in congenital heart surgery: review and current evidence

2020 ◽  
Author(s):  
Debasis Das ◽  
Nilanjan Dutta ◽  
Kuntal Roy Chowdhuri
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Circulatory Arrest ◽  
Congenital Heart Surgery ◽  
Current Evidence ◽  
Total Circulatory Arrest

scholarly journals Neurodevelopmental Outcome After Congenital Heart Surgery: Results From an Institutional Registry

Circulation ◽  
2002 ◽  
Vol 106 (12_suppl_1) ◽  
Author(s):  
Joseph M. Forbess ◽  
Karen J. Visconti ◽  
Camille Hancock-Friesen ◽  
Robert C. Howe ◽  
David C. Bellinger ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Single Ventricle ◽  
Circulatory Arrest ◽  
Neurodevelopmental Outcome ◽  
Velocardiofacial Syndrome ◽  
Congenital Heart Surgery ◽  
Critical Congenital Heart Disease ◽  
Iq Scores ◽  
And Performance

Objective Increased survival in children with critical congenital heart disease (CHD) has raised interest in the neurodevelopmental sequelae of these lesions. This investigation is part of an institutional effort to examine the neurodevelopment of 5-year-old children following repair or palliation of CHD. Methods We performed a battery of neuropsychological tests on a sample of 243 children between 1998 and 2001. Results In the sample as a whole, mean full-scale (FSIQ), verbal (VIQ), and performance (PIQ) IQ scores were in the normal range (96.8±15.9, 97.8±14.6, and 96.3±17.1, respectively). Anatomic, demographic, and perioperative factors were assessed for impact on neurodevelopment. In multiple regression analysis, lower socioeconomic status (SES) and the diagnosis of velocardiofacial syndrome (VCFS) predicted a lower FSIQ ( P =0.01, and P =0.001, respectively). A single ventricle diagnosis ( P =0.06), longer postoperative ICU stay ( P =0.08), and cumulative duration of hypothermic circulatory arrest (HCA) ( P =0.09) approached significance as predictors of lower FSIQ. Conclusion Children with CHD, on the whole, appear to be performing within the average range in terms of intellectual abilities. Lower SES and VCFS are associated with lower IQ scores. Trends toward worse outcomes were observed in single ventricle patients, biventricular patients with longer postrepair ICU stays, and patients subjected to longer periods of HCA.

scholarly journals LONG-TERM TRANSPLANT-FREE SURVIVAL AFTER CONGENITAL HEART SURGERY

2021 ◽  
Vol 77 (18) ◽  
pp. 481
Author(s):  
Lazaros Kochilas ◽  
Amanda Thomas ◽  
Chao Zhang ◽  
J’Neka Claxton ◽  
Courtney McCracken ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Free Survival

Early Extubation in a Pediatric Cardiac Surgery Program Located at High Altitude

2021 ◽  
Vol 12 (4) ◽  
pp. 473-479
Author(s):  
Orlando José Tamariz-Cruz ◽  
Luis Antonio García-Benítez ◽  
Hector Díliz-Nava ◽  
Felipa Acosta-Garduño ◽  
Marcela Barrera-Fuentes ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Operating Room ◽  
Sea Level ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Anesthetic Management ◽  
Fontan Procedure ◽  
Congenital Heart Surgery ◽  
Serum Lactate ◽  
Early Extubation

Background: Early extubation is performed either in the operating room or in the cardiovascular intensive care unit during the first 24 postoperative hours; however, altitude might possibly affect the process. The aim of this study is the evaluation of early extubation feasibility of patients undergoing congenital heart surgery in a center located at 2,691 m (8,828 ft.) above sea level. Material and Methods: Patients undergoing congenital heart surgery, from August 2012 through December 2018, were considered for early extubation. The following variables were recorded: weight, serum lactate, presence or not of Down syndrome, optimal oxygenation and acid–base status according to individual physiological condition (biventricular or univentricular), age, bypass time, and ventricular function. Standardized anesthetic management with dexmedetomidine–fentanyl–rocuronium and sevoflurane was used. If extubation in the operating room was considered, 0.08 mL/kg of 0.5% ropivacaine was injected into the parasternal intercostal spaces bilaterally before closing the sternum. Results: Four hundred seventy-eight patients were operated and 81% were early extubated. Mean pre- and postoperative SaO2 was 92% and 98%; postoperative SaO2 for Glenn and Fontan procedures patients was 82% and 91%, respectively. Seventy-three percent of patients who underwent Glenn procedure, 89% of those who underwent Fontan procedure (all nonfenestrated), and 85% with Down syndrome were extubated in the operating room. Reintubation rate in early extubated patients was 3.6%. Conclusion: Early extubation is feasible, with low reintubation rates, at 2,691 m (8,828 ft.) above sea level, even in patients with single ventricle physiology.

Sign in / Sign up

Export Citation Format

Share Document