The outcome of Antegrade Cerebral Perfusion during Deep Hypothermic Circulatory Arrest in Pediatric Arch Surgery

Abstract

Background: Techniques for the surgical correction of aortic aneurysms have steadily improved since the first described successful repair, Despite these improvements, postoperative neurological complications remain a major factor in determining an adverse outcome.Complex aortic arch reconstruction in neonates and children is performed typically under deep hypothermic circulatory arrest. Aim: The study aimed at examining the effect of clinical impact, particularly neurologic complications, of deep hypothermic circulatory arrest in pediatric arch surgery and to summarize the early outcomes. Patients and method: One-handed and fourteen underwent full-term babies were enrolled in the present study .The maximum age was 20 weeks, arch surgery included Norwood, arch reconstruction for hypoplastic arch and interrupted aortic arch. Healthy neurological status preoperative was included between January 2011 and October 2015. The medical records were reviewed for preoperative diagnosis of patients which included age at the time of operation, sex and diagnosis of the patients. Operative details including type of the operation, duration of cross-clamp and deep hypothermic circulatory arrest timing were documented. The deep hypothermic circulatory arrest was conducted at 20 ℃. Postoperative outcomes, neurological complications including seizers, cerebral infarct, and duration of hospital stay were recorded. Results: The study noted that the incidence of postoperative complications such as seizure & bleeding was markedly 5.3%& 1.8% of the studied pediatric patients. Conclusion: The results concluded that the aortic arch reconstruction with Antegrade cerebral perfusion during the deep hypothermic circulatory arrest was accompanied by a lower risk of neurological complications. Recommendations: Long-term neurodevelopmental follow-up of these children is required to evaluate the late outcomes of Antegrade cerebral perfusion.