Usefulness of Deep Hypothermic Circulatory Arrest and Regional Cerebral Perfusion in Children.
To compare the safety and usefulness of deep hypothermic circulatory arrest (DHCA) and regional cerebral perfusion (RCP) during pediatric open heart surgery. Between January 1, 2004 and September 30, 2012, 1250 children with congenital cardiac defect underwent corrective operation with the DHCA or RCP technique in the Shanghai Children's Medical Center. Of them, 947 cases underwent the operation with the aid of DHCA (DHCA group), and 303 cases with RCP (RCP group). The mean DHCA time was 30.64±15.81 (7-63) minutes and mean RCP time was 36.18±12.86 (10-82) minutes. The mortality rate was 7.18% (68/947) and 6.60% (20/30) in two groups, respectively. The postoperative incidences of temporary and permanent neurological dysfunction were 6.23% (59/947) in the DHCA group and 2.64% (8/303) in the RCP group (p<0.01). The incidence of other complications such as low cardiac output, renal dysfunction, and lung issues are similar in both groups. RCP is a reliable technique for cerebral protection and it facilitates time-consuming corrected procedures for complex congenital cardiac defect repair procedures.
Department of Pediatric Thoracic and cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine , Shanghai, People's Republic of China .
Zheng
Z
Guo
Ren-Jie
RJ
Hu
De-Ming
DM
Zhu
Zhong-Qun
ZQ
Zhu
Hai-Bo
HB
Zhang
Wei
W
Wang