Ci. Tchervenkov et al., Surgical technique to avoid circulatory arrest and direct arch vessel cannulation during neonatal aortic arch reconstruction, EUR J CAR-T, 19(5), 2001, pp. 708-710
Deep hypothermic circulatory arrest (DHCA) has been used routinely for surg
ery involving the aortic arch. Recently, techniques have been developed tha
t avoid circulatory arrest and maintain low-flow cerebral perfusion (LFCP)
in an attempt to avoid the potential neurological sequelae associated with
DHCA. We describe a technique of LFCP that avoids circulatory arrest and di
rect cannulation of the arch vessels. Five patients underwent reconstructio
n of the aortic arch with concomitant biventricular intracardiac repair. Th
e distal ascending aorta was cannulated and patients were systemically cool
ed. The cannula was advanced into the innominate artery and snared in place
prior to opening and reconstructing the aorta with continuous LFCP. In all
five patients, we completely avoided circulatory arrest and direct cannula
tion of the arch vessels. All patients survived and there were no adverse n
eurological outcomes. (C) 2001 Elsevier Science B.V. All rights reserved.