Outcomes of deep hypothermic circulatory arrest in pediatric cardiac surgery: A single center experience

AbstractBackgroundDeep hypothermic circulatory arrest (DHCA) is a technique used in the repair of complex congenital cardiac lesions that require aortic arch or pulmonary vein repair. DHCA has been linked to adverse outcomes and neurologic complications. Selective cerebral perfusion (SCP) may be added to DHCA to prevent neurological complication. Air embolism and hyperperfusion injury may be encountered. The aim of this study was to evaluate the safety and efficacy of simple DHCA and to outline the early outcomes especially the neurological ones.MethodsTwenty nine patients underwent surgical repair of congenital cardiac lesion with DHCA at a single institution from January 2010 to November 2015. DHCA was conducted with a target esophageal temperature of 18° and placement of an ice pack on the head. No selective perfusion was done. Demographic, operative and postoperative data were reviewed. Mortality, any neurological complications including seizers, coma, and stroke were recorded.ResultsThe mean age was 20.6 ± 8.2 months (range: 9 days to 154 months). The majority were males (20, 69%). The mean weight was 5.57 ± 4.2 kg (range: 2.3–17.5 kg). DHCA time was 20.03 min (range 3–52 min). There were three (10.3%) deaths. Two deaths occurred after Norwood operation, and one after interrupted aortic arch repair. None of the deaths were related to neurological injury. None of the patients developed seizers, coma, abnormal movement or neurological deficits.ConclusionsSimple DHCA without SCP is a safe, expeditious and reliable method for brain protection during repair of complex cardiac lesions, with acceptable outcomes