Aortic arch and intracardiac repair without circulatory arrest in neonates and infants

Ali Rıza Karaci; Ahmet Şaşmazel; Reyhan Dedeoğlu; Numan Ali Aydemir; Buğra Harmandar; Hasan Erdem; Dicle Cengiz; Ahmet Çelebi; İbrahim Yekeler

doi:10.5606/tgkdc.dergisi.2014.8542

Ali Rıza Karaci¹, Ahmet Şaşmazel¹, Reyhan Dedeoğlu², Numan Ali Aydemir¹, Buğra Harmandar¹, Hasan Erdem³, Dicle Cengiz⁴, Ahmet Çelebi², İbrahim Yekeler¹

Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
¹Departments of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
²Departments of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
³Department of Cardiovascular Surgery, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
⁴Department of Statistics, İstanbul Commerce University, İstanbul, Turkey

DOI : 10.5606/tgkdc.dergisi.2014.8542

Background: In this article, we aimed to report our surgical experiences with selective antegrade cerebral perfusion combined with the aortic arch and intracardiac surgery in neonates and infants.

Methods: Medical data of 27 consecutive patients (18 boys, 9 girls; mean age 9.9+1.7 days; range 1 to 26 days) who undergoing aortic arch and intracardiac repair between March 2007 and April 2012 were retrospectively analyzed. The link between perioperative risk factors and 30-day mortality following surgery were investigated.

Results: The mean body weight of patients were 3.2±0.9 kg. Major associated cardiac defects were present in 12 and included truncus arteriosus (Vaan Pragh type 4) (n=2), transposition of the great arteries (n=5), double outlet right ventricle with Taussing Bing anomaly (n=2), and aortopulmonary window defect (n=3). Renal insufficiency and dialysis were statistically significantly associated with mortality [Chi square 27 (p=0.000) and 20.66 (p=0.000), respectively].

Conclusion: Aortic arch repair with simultaneous intracardiac surgical repair can be done with selective antegrade cerebral perfusion at a single stage in neonates and infants.

Keywords : Antegrade cerebral perfusion; aortic arch intracardiac surgery; neonatal infant

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