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Simple deep hypothermia for open heart surgery in infancy

R Wakusawa, S Shibata, K Okada

    Canadian Anaesthetists' Society Journal
    |July 1, 1977
    PubMed
    Summary

    Deep hypothermia enables open heart surgery in infants under 10 kg, with a 14% mortality rate. Respiratory management remains a key challenge post-surgery.

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    Area of Science:

    • Pediatric Cardiac Surgery
    • Hypothermia in Infants
    • Anesthetic Management

    Background:

    • Open cardiac surgery in infants weighing less than 10 kg presents significant challenges.
    • Deep hypothermia has been explored as a method to facilitate complex cardiac procedures in this population.

    Purpose of the Study:

    • To report the outcomes of open cardiac surgery performed under deep simple hypothermia in 121 infants weighing less than 10 kg.
    • To evaluate the safety and efficacy of a specific anesthetic regimen for deep hypothermia.

    Main Methods:

    • The study involved 121 infants undergoing open cardiac surgery with deep surface-induced hypothermia.
    • Anesthetic management included deep ether anesthesia and triflupromazine (3 mg/kg).
    • Mean lowest esophageal temperature reached 20.8°C, rectal temperature 18.9°C, with a mean circulatory arrest time of 40 minutes.

    Main Results:

    • Seventeen infants (14.0%) died post-operatively.
    • No operative deaths were attributed to failure of cardiac resuscitation.
    • The technique successfully facilitated open heart surgery in this small infant cohort.

    Conclusions:

    • Deep simple hypothermia, combined with the described anesthetic technique, is a viable method for open cardiac surgery in infants under 10 kg.
    • This approach expands the possibilities for surgical correction of congenital heart defects in neonates.
    • Post-operative respiratory management is identified as the primary challenge, outweighing the risks of hypothermia itself.

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