Simple deep hypothermia for open heart surgery in infancy

Results of open cardiac surgery under deep simple hypothermia in 121 infants with body weight of less than 10 kg are reported. Deep ether anaesthesia combined with large quantities of ganglion blocking agents (triflupromazine 3 mg/kg) constitutes the anaesthetic management of choice for deep surface-induced hypothermia. The mean lowest oesophageal temperature was 20.8 degrees C, and 18.9 degrees C rectally. The mean circulatory arrest time was 40 minutes. Seventeen infants (14.0 per cent) died post-operatively. There were no operative deaths attributable to failure of cardiac resuscitation. This technique widens the scope of open heart surgery in small infants. Most of the surgically correctable malformations should be operable by this method. More than the potential hazards of hypothermia, which we believe are solved by our technique, the major problem posed by surgery in these small infants is the trans and post-operative respiratory management.