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Cardiac surgery under perfusionless hypothermia: Siberian experience
Alexander M Karaskov1, C Saifuddin Kitchlu, Vladimir N Lomivorotov
1Department of Cardiac Surgery, Research Institute of Circulation Pathology, 15 Rechkunovskaya str. 630055, Novosibirsk 55, Russia.
Asian Cardiovascular & Thoracic Annals
|June 25, 2002
Summary
Perfusionless hypothermic cardiac surgery is a safe and simple method for correcting congenital heart defects in select patients. This technique, utilizing crushed ice for hypothermia, demonstrated a low mortality rate and no neurological deficits in survivors.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Hypothermia Techniques
Background:
- Congenital heart defects require surgical correction.
- Hypothermic cardiac surgery is a common approach.
- Perfusionless techniques offer potential advantages.
Purpose of the Study:
- To evaluate the safety and efficacy of perfusionless hypothermic cardiac surgery.
- To assess outcomes in patients undergoing this procedure for congenital heart defects.
- To determine the suitability of this method for specific patient groups.
Main Methods:
- Retrospective analysis of 942 patients (1-51 years) undergoing surgery between 1995-1999.
- Application of crushed ice for hypothermia (24°C-28°C) without cardiopulmonary bypass.
- Focus on uncomplicated ventricular or atrial septal defects (80% of cases).
Main Results:
- Low postoperative mortality rate of 0.85% (8 patients).
- Causes of death included cardiac insufficiency, technical faults, pulmonary hypertension, and cardiac arrest.
- No gross neurological deficits observed in surviving patients.
- Mean aortic crossclamp time: 26.1 minutes; mean cardiac restoration time: 2.1 minutes.
Conclusions:
- Perfusionless hypothermic cardiac surgery is a safe and simple procedure.
- The technique is suitable for a selected group of patients with uncomplicated congenital heart defects.
- Appropriate application of this method can yield positive patient outcomes.
