[Application of the warm heart surgery to the open heart surgery in children]

Application of the warm heart surgery to the children's open heart surgery has been reluctant, because keeping the operative field dry thought to be difficult. In this report, the clinical result of 22 cases of children's open heart surgery using warm heart surgery (Warm Group) was compared with that of other 25 cases using conventional cold cardioplegia (Cold Group). In warm group, rectal temperature was kept at 34 degrees C, continuous coronary perfusion rate was 3 ml/kg/min, and potassium ion concentration for inducing the initial cardiac arrest was 20 mEq/l, and the maintaining dose was 12-17 mEq/l. There were two deaths in Cold group. In warm group, keeping the operative field dry was not difficult by using the specially devised small sucker (2 mm diameter) and, if necessary, temporarily stopping the coronary perfusion (maximum for 7 min). Aorta cross cramping time/total extracorporeal circulation time, CK-MB at 1-POD and maximum dose of dopamine and dobutamine proved the better myocardial protection in warm group (p < 0.01). From this study, it was concluded that warm heart surgery can be applied for children with no difficulty, and showed superior myocardial protection.