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J Thorac Cardiovasc Surg 2007;133:1096-1098
© 2007 The American Association for Thoracic Surgery

Brief Communication

Infant arch reconstruction during total system perfusion

Aimee B. Gardner, BS, CCP*, Pirooz Eghtesady, MD, PhD

Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.

Received for publication October 25, 2006; accepted for publication October 30, 2006.

* Address for reprints: Aimee B. Gardner, BS, CCP, Cincinnati Children’s Hospital Medical Center, Cardiothoracic Surgery, 3333 Burnet Ave, MLC 2004, Cincinnati OH 45229. (Email: Aimee.gardner@cchmc.org).

The first 20% of the full text of this article appears below.

Currently, neonatal arch reconstruction requires the use of circulatory arrest or, predominantly, regional cerebral perfusion techniques.1Go With regional perfusion, the question remains as to the adequacy of brain perfusion.2,3Go Recent clinical and experimental evidence suggests that, with all techniques, systemic perfusion is sacrificed and unwanted effects of deep hypothermia remain. With the use of the INVOS cerebral oximeter (Somanetics, Troy, Mich), changes in the regional cerebral oxygen saturation are now noninvasively and continuously monitored, allowing for the comparison of different techniques. We present a case of successful aortic arch reconstruction in an infant using a novel technique that allows total cerebral as well as systemic perfusion during arch reconstruction.

Clinical Summary

A 6-month-old infant with Shone’s anomaly, who had undergone a previous repair of coarctation of aorta and total anomalous pulmonary venous return, developed a new arch that narrowed between the innominate artery and left carotid takeoff. Because of worsening left ventricular hypertrophy, increased left . . . [Full Text of this Article]






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Copyright © 2007 by The American Association for Thoracic Surgery.