title: [Outcome of the Pediatric Patients Who Required Repeated Cardiopulmonary Bypass during the Repair of Congenital Heart Disease].
abstract: BACKGROUND
  We occasionally encounter clinical deterioration after discontinuation of cardiopulmonary bypass (CPB) and are forced to reinstitute CPB during cardiac surgery. Some reports describe such cases occurring in adults, but few in infants and children. We retrospectively investigated the causes and outcomes of children requiring repeated CPB during the repair of congenital heart anomalies.
  
  
  METHODS
  Patients who required repeated CPB during the repair of congenital heart anomalies in our institution from 2007 to 2012 were recruited into the study. Patient's background, diagnosis, surgical procedures, durations of total CPB and aortic cross-clamping, indications for re-CPB, procedures or treatment added after reinstitution of CPB and outcomes were collected.
  
  
  RESULTS
  Out of 600 pediatric patients who underwent the repair of congenital heart disease during the study period, 34 required repeated CPB and were enrolled into the study. Mean age was 2 years and mean body weight was 9.9 kg. Twenty-six patients of 34 were weaned from the CPB after additional surgical repair with re-bypass, one of whom died in the ICU. The remaining 8 patients were weaned from the CPB after medical treatment. One of 8 patients died in the ICU and 2 died after discharge from ICU.
  
  
  CONCLUSIONS
  In cardiac surgery of congenital heart disease, pediatric patients who required repeated CPB showed high mortality but patients who received additional surgical repair to be weaned from CPB had better outcome compared with those who received medical treatment.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Terada
authors.forename: Kazuya
authors.initials: K
authors.lastname: Tachibana
authors.forename: Muneyuki
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Kinouchi
mesh_terms: D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing