Korean J Thorac Cardiovasc Surg.  2006 Jun;39(6):434-439.

One Stage Total Repair of the Aortic Arch Anomaly using the Regional Perfusion

• Jang WS
• Kim WH
• Lim C
• Lim HK
• Min SK
• Kwak JK
• Chung ES
• Kim DJ

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.

Keyword

Regional blood flow; Aorta, arch; Hypothermia; Neurocognitive deficits

MeSH Terms

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