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[Open-heart surgery during deep hypothermia in infancy]
Insights
Early surgical correction of severe congenital heart defects in infants using profound hypothermia and circulatory arrest showed improved outcomes with extracorporeal circulation (ECC). ECC significantly reduced mortality rates in these complex pediatric cardiac surgeries.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Defects
- Hypothermic Circulatory Arrest
Context:
- Severe congenital heart defects require early surgical intervention in infants.
- Profound hypothermia and circulatory arrest are critical techniques in complex pediatric cardiac surgery.
- Extracorporeal circulation (ECC) plays a vital role in supporting infants during these procedures.
Purpose:
- To evaluate the outcomes of early total correction for severe congenital heart defects in infants.
- To compare the mortality rates of infants operated with and without extracorporeal circulation (ECC) under profound hypothermia.
- To identify the most common congenital heart defects requiring this surgical approach.
Summary:
- A study of 47 infants with severe congenital heart defects undergoing early total correction using profound hypothermia (22°C) and circulatory arrest.
- Mortality was significantly lower (22%) in infants utilizing extracorporeal circulation (ECC) compared to those operated without ECC (63%).
- Common diagnoses included atrioventricular canal, aortic stenosis, tetralogy of Fallot, ventricular septal defect, and transposition of the great arteries.
Impact:
- The findings highlight the improved survival rates associated with using extracorporeal circulation in infants undergoing complex cardiac surgery.
- This research provides critical data for surgical decision-making in the management of severe congenital heart defects in neonates and infants.
- The study underscores the importance of advanced cardiopulmonary support technologies in pediatric cardiac interventions.
Abstract:
A total of 47 infants (2,7 to 9,6 kg in weight, 3 days to 21 months of age, 89% under one year) underwent early total correction of severe congenital heart defects in profound hypothermia of about 22degreesC and circulatory arrest (11 to 64 minutes). 8 patients were operated upon without extracorporeal circulation (ECC) (mortality 63%). 37 infants were additionally cooled and rewarmed with ECC (mortality 22%). The most common diagnosis were: Total atrioventricular canal (11), aortic stenosis with and without combined lesions (8), tetralogy of Fallot (7), ventricular septum defect (7) and transposition of the great arteries (4).