DEEP HYPOTHERMIA WITHOUT EXTRACORPOREAL-CIRCULATION IN SURGERY OF CONGENITAL CARDIAC DEFECTS

Operations on the open heart under perfusionless deep hypothermia were performed in 3,141 patients with congenital cardiac defects. The pati ents ages ranged from 3 months to 44 years. The body was cooled to 26- 24-degrees-C by covering with crushed ice. Cooling was performed under conditions of not deep ether anesthesia with the use of minimum doses of narcotic analgetics (morphine 0. 5 mg/kg). Lactacidemia was regist ered during hypothermia. In contrast to lactate, the content of fatty acids and 11-hydroxycorticosteroids during all the stages of hypotherm ia did not change significantly. The time of circulatory arrest ranged from 10-89 min. It took 2-7 min to restore cardiac activity. Of 3,141 patients operated on, 265 died (8.44%). The mortality pattern demonst rated that the major cause of death was cardiac insufficiency (5.9%). Neurological sequelae were observed in 110 patients (3.5 %). Based on the results of tests with Luria's neuropsychological method, neurologi cal disturbances were registered in 15.4% of patients. The frequencies of neuropsychological complications were not related to the time of c irculatory arrest. Unstable hemodynamics after operation was the most contributory factor to the development of neurological complications. Perfusionless deep hypothermia is an efficient method providing condit ions for performance of open heart operations, and it can be used in s urgical repair of congenital cardiac defects.