Application of moderate hypothermia while performance of the aortal arch reconstruction in new-born babies in conditions of selective antegrade cerebral perfusion

Keywords: selective antegrade cerebral perfusion; moderate hypothermia; aortic arch.

Abstract

Objective. To estimate a security of application of moderate hypothermia while performing the aortal arch reconstruction in new-born babies in conditions of selective antegrade cerebral perfusion.

Materials and methods. In 2010-2019 yrs period in Amosov National Institute of Cardiovascular Surgery and Scientific-Practical Medical Centre of Pediatric Cardiology and Cardio-Surgery in 64 new-born babies the aortal arch reconstruction was performed in conditions of selective antegrade cerebral perfusion in moderate hypothermia. In the investigation only patients with a two-ventricle physiology, in whom further two-ventricular correction was conducted, were included. There were 48 (75%) boys and 16 (25%) girls. Median age of the patients was (1.6 ± 0.8) mo, median body mass - (3.8 ± 1.1) kg, median square of the body surface - (0.24 ± 0.04) m². Echocardiographic investigation and neurosonography were the main diagnostic procedures.

Results. Hospital mortality have constituted 4.7% (3 patients died). The death cases were not connected with the brain protection procedure. Duration of artificial blood circulation period have had constituted (138.4 ± 58.8) min at average, aortal clamping - (83.1 ± 40 min), selective antegrade cerebral perfusion - (24.4 ± 8.8) min. In 10 (15,6%) patients in early postoperative period the sternum persisted open. In 4 (6.2%) patients in early postoperative period convulsions were noted, which were treated successfully medicinally. Median stay in the Department of Reanimation and Intensive Therapy have constituted (7.1 ± 4.1) days. In late follow-up period the patients were seen from 1 mo till 8.5 yrs. No one patient died. While elective neurosonography conduction the brain pathological changes were absent. The neurological complications symptoms were absent as well.

Conclusion. Selective antegrade cerebral perfusion with moderate hypothermia constitutes effective and secure method of the brain protection while performance of the aortal arch reconstruction in new-born babies, using median surgical approach in conditions of artificial blood circulation.

Author Biographies

Ya. P. Truba, Amosov National Institute of Cardiovascular Surgery, Kyiv

Truba Sekelyk Dzyurii Golovenko Lazoryshynets Yaroslav P. - MD, DSci(Med),
Head of Department of Congenital Heart Disease
Amosov National Institute of Cardiovascular Surgery, Kyiv;
03038, Ukraine, Kyiv, 6, N. Amosov str
+380 44 275-64-00
truba-mena@rambler.ru
orcid.org/0000-0001-5214-408X

R. І. Sekelyk, Scientific-Practical Medical Centre of Pediatric Cardiology and Cardio-Surgery, Kyiv

Sekelyk Roman I. - MD, Cardiac surgeon,
Department of Congenital Heart Disease
Center For Pediatric Cardiology and Cardiac Surgery, Kyiv
Kyiv, 28/1, Chornovola st.
(044) 238-78-07
sekelyk@ukr.net
orcid.org/0000-0001-9951-827X

І. V. Dzyurii, Amosov National Institute of Cardiovascular Surgery, Kyiv

Dzyurii Ivan V. - MD, Cardiac surgeon,
Department of Congenital Heart Disease
Amosov National Institute of Cardiovascular Surgery, Kyiv;
03038, Ukraine, Kyiv, 6, N. Amosov str
+380 44 275-64-00 ivandzyurii@gmail.com.
orcid.org/0000-0002-1073-7060

O. S. Golovenko, Amosov National Institute of Cardiovascular Surgery, Kyiv

Golovenko Olexandr S. - MD, DSci (Med),
Head Scientific Researcher of Department of Congenital Heart Disease
Amosov National Institute of Cardiovascular Surgery, Kyiv;
03038, Ukraine, Kyiv, 6, N. Amosov str
+380 44 275-64-00
dr.golovenko@gmail.com
orcid.org/0000-0001-6002-3325

V. V. Lazoryshynets, Amosov National Institute of Cardiovascular Surgery, Kyiv

Lazoryshynets Vasyl V. - MD, DSci(Med),
Director of Amosov National Institute of Cardiovascular Surgery,
Amosov National Institute of Cardiovascular Surgery, Kyiv;
03038, Ukraine, Kyiv, 6, N. Amosov str
+380 44 275-64-00 lazorch@ukr.net
orcid.org/0000-0002-1748-561X

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Published
2020-10-29
How to Cite
Truba, Y. P., SekelykR. І., DzyuriiІ. V., Golovenko, O. S., & Lazoryshynets, V. V. (2020). Application of moderate hypothermia while performance of the aortal arch reconstruction in new-born babies in conditions of selective antegrade cerebral perfusion. Klinicheskaia Khirurgiia, 87(9-10), 35-39. https://doi.org/10.26779/2522-1396.2020.9-10.35
Section
General Problems of Surgery