title: Deep hypothermic circulatory arrest for hemiarch replacement in a pediatric patient with moyamoya disease.
abstract: Moyamoya disease is a chronic cerebrovascular occlusive disease, occurring predominantly in young populations, that causes cerebral ischemia and hemorrhage. Patients with moyamoya disease are at high risk of neurological complications during cardiac surgery because of perioperative hemodynamic changes. However, there is no established evidence on temperature management during cardiopulmonary bypass. Previous reports described normothermia or mild to moderate hypothermia during cardiopulmonary bypass in patients with moyamoya disease; however, surgical conditions, such as not having enough space to clamp the aorta or a clean surgical field, sometimes force us to use deep hypothermic circuratory arrest. We report a successful case of a pediatric patient with moyamoya disease who underwent deep hypothermic circulatory arrest (18 °C) for hemiarch replacement without neurological complications. Deep hypothermia may be an alternative technique for achieving cerebral protection in the context of moyamoya disease.
authors.affiliation: Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan, kuwajima31@ybb.ne.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Kuwajima
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshitani
authors.forename: Shinya
authors.initials: S
authors.lastname: Kato
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyazaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Kamei
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ohnishi
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D002648:Child; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D005260:Female; D006801:Humans; D009072:Moyamoya Disease / Q000601:surgery*; D010101:Oxygen Consumption