Cardiac surgery under perfusionless hypothermia: Siberian experience.
Between January 1995 and December 1999, 942 patients (452 males and 490 females) aged 1 to 51 years underwent definitive surgery under perfusionless hypothermia for correction of congenital heart defects, predominantly uncomplicated ventricular or atrial septal defects (80%). Hypothermia of 24 degrees C to 28 degrees C was achieved in 15 to 45 minutes (mean, 25.7 +/- 1.2 minutes) by application of crushed ice over the body and head. Aortic crossclamp time ranged from 10 to 76 minutes (mean, 26.1 +/- 0.25 minutes). Cardiac restoration time ranged from 1 to 10 minutes (mean, 2.1 +/- 0.08 minutes). Eight patients (0.85%) died postoperatively: 4 from acute cardiac insufficiency, 2 as a consequence of technical faults, 1 from persistent pulmonary hypertension, and 1 had sudden cardiac arrest. None of the surviving patients showed any gross neurological deficit. Perfusionless hypothermic cardiac surgery, when applied appropriately, is safe and simple, and might still have a place in treating a selected group of patients with uncomplicated congenital heart defects.
Karaskov
Alexander M
AM
Department of Cardiac Surgery, Research Institute of Circulation Pathology, 15 Rechkunovskaya str. 630055, Novosibirsk 55, Russia.
Kitchlu
C Saifuddin
CS
Lomivorotov
Vladimir N
VN
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006324:Heart Arrest, Induced; D006330:Heart Defects, Congenital / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007036:Hypothermia, Induced; D007223:Infant; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D012800:Siberia; D016896:Treatment Outcome