OUTCOMES AFTER ONE-STAGE REPAIR OF COARCTATION OF THE AORTA AND COMBINED INTRACARDIAC LESIONS IN INFANTS

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Abstract

Background: The aim of the study was to compare the outcomes of hypothermic circulatory arrest (GCA) and selective cerebral perfusion (SCP). Patients and methods: Nine patients were treated at the Bakoulev Center for Cardiovascular Surgery. All congenital heart diseases were repaired simultaneously. Group 1 (n =4) included infants who were treated using an HCA, and the patients who underwent repair with the use of SCP were in group 2 (n =5). Results: One patient (25%) in group 1 died in the period of thirty days after the repair. Moderate heart failure and respiratory failure occurred postoperatively with no significant difference between two groups. Recoarctation was a frequent (75%) complication after the «end to end» anastomosis creating. One patient (25%) was reoperated on day 3 after the primary repair. Two other patients (50%) were treated by balloon angioplasty. There was relatively high (75%) incidence of a prolonged open sternotomy in group 1. Conclusion: There were similar results in HCA and SCP groups. A tendency for frequent prolonged open sternotomy application after HCA surgery as well as occurrence of the recoarctation after «end to end» anastomosis creating was found.

About the authors

A. I. Kim

Bakoulev Centre for Cardiovascular Surgery, Moscow

Author for correspondence.
Email: aikim@bakulev.ru
PhD, professor, cardiac surgeon of the Department of Reconstructive Surgery of Newborns and Infants of Clinic for Congenital Heart Diseases of the Bakoulev Center for Cardiovascular Surgery (Bakoulev CCVS) Russian Federation

S. N. Metlin

Bakoulev Centre for Cardiovascular Surgery, Moscow, Russian Federation

Email: snmetlin@bakulev.ru

MD, junior research scientist of the Department of Reconstructive Surgery of Newborns and Infants of Clinic for Congenital Heart Diseases of the Bakoulev Center for Cardiovascular Surgery (Bakoulev CCVS). Address: 135, Rublevskoe Highway, Moscow, RF; tel.: +7 (495) 414-76-15

Russian Federation

N. A. Ermilova

Bakoulev Centre for Cardiovascular Surgery, Moscow, Russian Federation

Email: naermilova@bakulev.ru

anesthesiologist the Department of Reconstructive Surgery of Newborns and Infants of Clinic for Congenital Heart Diseases of the Bakoulev Center for Cardiovascular Surgery (Bakoulev CCVS). Address: 135, Rublevskoe Highway, Moscow, RF; tel.: +7 (495) 414-75-08

Russian Federation

References

  1. Newburger J.W., Jonas R.A., Wernovsky G. A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart surgery. N. Engl. J. Med. 1993; 329: 1057–64.
  2. Andropoulos D.B., Easley R.B., Brady K., McKenzie E.D., Heinle J.S., Dickerson H.A. et al. Neurodevelopmental outcomes after regional cerebral perfusion with neuromonitoring for neonatal aortic arch reconstruction. Ann. Thorac. Surg. 2013; 95 (2): 648–655.
  3. Kwak J.G., Kim W.H., Kim J.T., Kim I.O., Chae J.H. Changes of brain magnetic resonance imaging findings after congenital aortic arch anomaly repair using regional cerebral perfusion in neonates and young infants. Ann. Thorac. Surg. 2010; 90 (6): 1996–2000.
  4. Wang J., Ginther R.M., Riegel M., Huang R., Sharma M.S., Guleserian K.J. et al. The impact of temperature and pump flow rate during selective cerebral perfusion on regional blood flow in piglets. J. Thorac. Cardiovasc. Surg. 2013; 145 (1): 188–195.
  5. Sakurada T., Kazui T., Tanaka H., Komatsu S. Comparative experimental study of cerebral protection during aortic arch reconstruction. Ann. Thorac. Surg. 1996; 61: 1348–1354.
  6. Tchervenkov C.I., Chu V.F., Shum-Tim D., Laliberte E., Reyes T.U. Norwood operation without circulatory arrest (a new surgical technique). Ann. Thorac. Surg. 2000; 70: 1730–1733.
  7. Pigula F.A., Nemoto E.M., Griffith B.P., Siewers R.D. Regional low-flow perfusion provides cerebral circulatory support during neonatal aortic arch reconstruction. J. Thorac. Cardiovasc. Surg. 2000; 119: 331–339.
  8. Asou T., Kado H., Imoto Y. Selective cerebral perfusion technique during aortic arch repair in neonates. Ann. Thorac. Surg. 1996; 61: 1546–1548.
  9. Imoto Y., Kado H., Shiokawa Y., Fukae K., Yasui H. Norwood procedure without circulatory arrest. Ann. Thorac. Surg. 1999; 68: 559–561.
  10. Ishino K., Kawada M., Irie H., Kino K., Sano S. Single-stage repair of aortic coarctation with ventricular septal defect using isolated cerebral and myocardial perfusion. Eur. J. Cardiothorac. Surg. 2000; 17: 538–542.
  11. McElhinney D.B., Reddy V.M., Silverman N.H., Hanley F.L. 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. Surg. 1997; 114: 718–726.
  12. Lim H.G., Kim W.H., Park C.S., Chung E.S., Lee C.H., Lee J.R. et al. Usefulness of regional cerebral perfusion combined with coronary perfusion during one-stage total repair of aortic arch anomaly. Ann. Thorac. Surg. 2010; 90 (1): 50–57.
  13. Bokeriya L.A., Kim A.I., Metlin S.N. Detskie bolezni serdtsa i sosudov = Child diseases of heart and blood vessels. 2011; 1: 44–48.
  14. Metlin S.N. Khirurgicheskoe lechenie defekta aortolegochnoi peregorodki u novorozhdennykh i detei pervogo goda zhizni. Avtoref. dis. ... kand. med. nauk [Surgical Treatment of the Aortopulmonary Window in Neonates and Infants. Author’s abstract]. Moscow, 2012. pp. 10–11.
  15. Sood E.D., Benzaquen J.S., Davies R.R., Woodford E., Pizarro C. Predictive value of perioperative near-infrared spectroscopy for neurodevelopmental outcomes after cardiac surgery in infancy. J. Thorac. Cardiovasc. Surg. 2013; 145 (2): 438–445.

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