Aortic arch reconstruction in neonates without hypothermic circulatory arrest

2002 ◽  
Vol 123 (6) ◽  
pp. 1221-1221 ◽  
Author(s):  
Luca A. Vricella ◽  
Michael D. Black
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction

Aortic arch reconstruction: deep and moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion

Perfusion ◽  
2017 ◽  
Vol 32 (5) ◽  
pp. 389-393 ◽  
Author(s):  
YanWen Wu ◽  
LiQiong Xiao ◽  
Ting Yang ◽  
Lei Wang ◽  
Xin Chen
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Brain Protection ◽  
Group I ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction ◽  
Selective Antegrade Cerebral Perfusion ◽  
Antegrade Cerebral Perfusion

Objective: To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) with selective antegrade cerebral perfusion (SACP) during aortic arch surgery in adult patients and to offer the evidence for the detection of the temperature which provides best brain protection in the subjects who accept aortic arch reconstruction surgery. Methods: A total of 109 patients undergoing surgery of the aortic arch were divided into the moderate hypothermic circulatory arrest group (Group I) and the deep hypothermic circulatory arrest group (Group II). We recorded the data of the patients and their cardiopulmonary bypass (CPB) time, aortic clamping time, SACP time and postoperative anesthetized recovery time, tracheal intubation time, time in the intensive care unit (ICU) and postoperative neurologic dysfunction. Results: Patient characteristics were similar in the two groups. There were four patients who died in Group II and 1 patient in Group I. There were no significant differences in aortic clamping time of each group (111.4±58.4 vs. 115.9±16.2) min; SACP time (27.4±5.9 vs. 23.5±6.1) min of the moderate hypothermic circulatory arrest group and the deep hypothermic circulatory arrest group; there were significant differences in cardiopulmonary bypass time (207.4±20.9 vs. 263.8±22.6) min, postoperative anesthetized recovery time (19.0±11.1 vs. 36.8±25.3) hours, extubation time (46.4±15.1 vs. 64.4±6.0) hours; length of stay in the intensive care unit (ICU) (4.7±1.7 vs. 8±2.3) days and postoperative neurologic dysfunction in the two groups. Conclusion: Compared to deep hypothermic circulatory arrest, moderate hypothermic circulatory arrest can provide better brain protection and achieve good clinical results.

scholarly journals Cannulation Strategy for Aortic Arch Reconstruction Using Deep Hypothermic Circulatory Arrest

2012 ◽  
Vol 94 (2) ◽  
pp. 614-620 ◽  
Author(s):  
Diane de Zélicourt ◽  
Philsub Jung ◽  
Marc Horner ◽  
Kerem Pekkan ◽  
Kirk R. Kanter ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction

Contemporary outcomes of aortic arch hypoplasia and coarctation repair in a tertiary paediatric cardiac surgery centre

2021 ◽  
pp. 1-6
Author(s):  
Amr Ashry ◽  
Amer Harky ◽  
Abdulla Tarmahomed ◽  
Christopher Ugwu ◽  
Heba M. Mohammed ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Recurrent Laryngeal Nerve Injury ◽  
Coarctation Repair ◽  
Aortic Arch Reconstruction ◽  
Retrospective Data Collection ◽  
Laryngeal Nerve Injury ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
Aortic Arch Hypoplasia

Abstract Objectives: There are several studies reporting the outcomes of hypoplastic aortic arch and aortic coarctation repair with combination of techniques. However, only few studies reported of aortic arch and coarctation repair using a homograft patch through sternotomy and circulatory arrest with retrograde cerebral perfusion. We report our experience and outcomes of this cohort of neonates and infants. Methods: We performed retrospective data collection for all neonates and infants who underwent aortic arch reconstruction between 2015 and 2020 at our institute. Data are presented as median and inter-quartile range (IQR). Results: The cohort included 76 patients: 49 were males (64.5%). Median age at operation was 16 days (IQR 9–43.25 days). Median weight was 3.5 kg (IQR 3.10–4 kg). There was no 30 days mortality. Three patients died in hospital after 30 days (3.95%), neurological adverse events occurred in only one patient (1.32%) and recurrent laryngeal nerve injury was noted in four patients (5.26%). Only three patients required the support of extracorporeal membrane oxygenation (ECMO) with a median ECMO run of 4 days. Median follow-up was 35 months (IQR 18.9–46.4 months); 5 years survival was 93.42% (n = 71). The rate of re-intervention on the aortic arch was 9.21% (n = 7). Conclusion: Our experience shows excellent outcomes in repairing aortic arch hypoplasia with homograft patch under moderate to deep hypothermia with low in-hospital and 5 years mortality rates.

scholarly journals Hypothermic circulatory arrest with or without antegrade cerebral perfusion for aortic arch surgery in infants

2019 ◽  
Vol 1 (3) ◽  
pp. 99-104
Author(s):  
Mohamed Abdel Fouly
Keyword(s):  
Cerebral Infarction ◽  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Aortic Arch Surgery ◽  
Significant Difference ◽  
Arch Reconstruction ◽  
Antegrade Cerebral Perfusion

Background: Antegrade cerebral perfusion (ACP) minimizes deep hypothermic circulatory arrest (DHCA) duration during arch surgery in infants, which may impact the outcomes of the repair. We aimed to evaluate the effect of adding antegrade cerebral perfusion to deep hypothermic circulatory arrest on DHCA duration and operative outcomes of different aortic arch operations in infants. Methods: We retrospectively collected data from infants (<20 weeks old) who underwent aortic arch reconstruction (Norwood operation, arch reconstruction for the hypoplastic arch and interrupted aortic arch) using DHCA alone (n=88) or combined with ACP (n=26). We excluded patients who had concomitant procedures and those with preoperative neurological disability. Results: There was no difference between groups as regards the age, gender, and the operation performed (p= 0.64; 0.87 and 0.50; respectively). Among the 114 patients, 11 (9.6%) had operative mortality, and 14 (12.3%) had cerebral infarction diagnosed with CT scanning. Adding ACP to DHCA significantly reduced DHCA duration from 50.7 ± 10.6 minutes to 22.4 ± 6.2 minutes (p<0.001) and lowered the mortality (11 vs. 0; p=0.066) and cerebral infarction (13 vs. 1; p=0.18). No statistically significant difference between the two groups in terms of ischemic time (p=0.63) or hospital stay duration (p=0.47). Conclusion: Using ACP appears to reduce the DHCA duration and was associated with better survival and neurological outcomes of aortic arch surgery in infants. A study with longer follow-up to evaluate the long-term neurological sequelae is recommended.

scholarly journals The analyze of neurological complications after aortic arch reconstruction in patients with proximal aortic dissection

2015 ◽  
Vol 17 (2) ◽  
pp. 35
Author(s):  
A. M. Chernyavskiy ◽  
S. A. Alsov ◽  
M. M. Lyashenko ◽  
D. A. Sirota ◽  
D. S. Khvan ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Neurological Complications ◽  
Pathological Process ◽  
Arterial Lesions ◽  
Aortic Arch Reconstruction ◽  
Almost All ◽  
Arch Reconstruction ◽  
The Brain

The article analyzes the neurological complications after interventions on the ascending aorta and the aortic arch in dissection I type by De Bakey. Group of authors investigated over a decade of experience in surgery of aortic dissection in both acute and chronic. Authors estimated the incidence of neurological complications after surgical intervention in 124 patients in the early post-operative and long term period. It were studied both qualitative measures (methods of reconstruction of the aortic arch, type of cerebral perfusion, the etiology of the pathological process, comorbidities) and quantitative (the duration of the different stages of surgery, age, height, weight). The analysis revealed that almost all cases of strokes were observed in the older age group and were associated with concomitant occlusive-stenotic arterial lesions caused by Takayasu's syndrome and atherosclerosis, as well as a set of related diseases. Increase in the number of strokes contribute to more complex, and therefore more time-consuming intervention types of reconstruction of the aortic arch. Antegrade perfusion of the brain, to our knowledge, did not have statistically significant advantages over retrograde perfusion or hypothermic circulatory arrest of the brain.

Sign in / Sign up

Export Citation Format

Share Document