title: Outcome of continuous cerebral and myocardial perfusion under mild hypothermia for aortic coarctation with ventricular septal defect repair.
abstract: BACKGROUND
  Controversy still exists on the use of the optimal cardiopulmonary bypass (CPB) management in aortic coarctation (CoA) with ventricular septal defect (VSD) repair. We report the outcome of patients undergoing continuous cerebral and myocardial perfusion (CCMP) under mild hypothermia.
  
  
  METHODS
  This is a retrospective analysis of 60 consecutive patients undergoing anatomic reconstruction of CoA with VSD closure between 1999 and 2011. Single arterial cannula perfusion technique was used in 15 (25%) patients, and a dual arterial cannula perfusion technique was used in 45 (75%) patients.
  
  
  RESULTS
  There were no hospital or late mortalities. Average CPB time was 105 ± 28 minutes, aortic clamp 27 ± 7 minutes, and descending aortic cross-clamp time 24 ± 5 minutes. Average continuous cerebral perfusion flow was 64 ± 8 mL/kg per minute. No patient needed delayed sternal closure. Average duration of ventilation was 38 ± 20 hours, ICU stay 7 ± 3 days, and hospital stay 14 ± 6 days. No patient required revision for bleeding and/or extracorporeal membrane oxygenation support. No neurologic complications were noted.
  
  
  CONCLUSIONS
  A perfusion strategy using CCMP with mild hypothermia for CoA and VSD repair is feasible and safe.
authors: Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Huiwen
authors: H
authors: Chen
authors: Haibo
authors: H
authors: Zhang
authors: Haifa
authors: H
authors: Hong
authors: Zhongqun
authors: Z
authors: Zhu
authors: Jinfen
authors: J
authors: Liu
mesh_terms: D001017:Aortic Coarctation / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007223:Infant; D008297:Male; D010477:Perfusion / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome