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Left heart bypass in the surgery of aortic coarctation in children
N J Buckels1, R G Willetts, K D Roberts
1Birmingham Children's Hospital.
Insights
Left heart bypass effectively ensured distal perfusion during aortic coarctation repair in children. While no deaths occurred, mild hemiparesis and pericardial effusion were noted complications.
Area of Science:
- Pediatric Cardiac Surgery
- Cardiovascular Surgery
- Congenital Heart Disease
Background:
- Aortic coarctation repair presents challenges in maintaining distal perfusion.
- Left heart bypass is a technique to address perfusion issues during aortic clamping.
Purpose of the Study:
- To evaluate the safety and efficacy of left heart bypass in pediatric aortic coarctation repair.
- To assess complications associated with left heart bypass during this procedure.
Main Methods:
- Retrospective analysis of 47 children undergoing aortic coarctation repair (1978-1985).
- Left heart bypass was utilized in 23 patients due to low distal aortic pressure (<50 mm Hg) or electively.
- Distal perfusion and patient outcomes were monitored.
Main Results:
- Satisfactory distal perfusion was achieved in all 23 patients who received left heart bypass.
- No deaths were directly related to the use of left heart bypass.
- Three complications were observed: one transient hemiparesis and two pericardial effusions.
Conclusions:
- Left heart bypass is a safe and effective method for ensuring distal perfusion during pediatric aortic coarctation repair.
- The incidence of serious complications related to left heart bypass in this cohort was low.
Abstract:
Of 47 children over the age of 1 year who underwent repair of aortic coarctation during 1978-85, 22 had the operation performed with left heart bypass because the distal aortic pressure was below 50 mm Hg after the initial application of the arterial clamps. One further child had an elective left heart bypass. Satisfactory distal perfusion was achieved in all 23 patients. There were no deaths related to the use of left heart bypass but three complications occurred. One child had a mild transient hemiparesis on the ninth postoperative day and two had a pericardial effusion.