Andrew J Lodge1, Nicholas D Andersen2, Joseph W Turek2. 1. Duke University Medical Center, Pediatric and Congenital Heart Center, Division of Cardiovascular and Thoracic Surgery, Box 3340, Durham, NC, 27710, USA. andrew.lodge@duke.edu. 2. Pediatric and Congenital Heart Center, Duke University Medical Center, Durham, NC, USA.
Abstract
PURPOSE OF REVIEW: This paper will discuss current cannulation strategies for infant aortic arch repair and compare them to more traditionally used techniques. RECENT FINDINGS: Aortic arch reconstruction in infants has traditionally involved deep hypothermic circulatory arrest which results in total body ischemia. This has been associated with an increased risk of morbidity including bleeding, renal dysfunction, and neurologic injury. Advances in perfusion techniques have allowed for preserved perfusion to the brain during arch repair. Current techniques have further evolved that allow for continuous perfusion of the heart and even the lower body during arch reconstruction. With current techniques, aortic arch reconstruction in infants can be performed with continuous perfusion to the brain, heart, and lower body. Further technical refinements will be helpful, and study is necessary to evaluate the benefit of these strategies.
PURPOSE OF REVIEW: This paper will discuss current cannulation strategies for infant aortic arch repair and compare them to more traditionally used techniques. RECENT FINDINGS: Aortic arch reconstruction in infants has traditionally involved deep hypothermic circulatory arrest which results in total body ischemia. This has been associated with an increased risk of morbidity including bleeding, renal dysfunction, and neurologic injury. Advances in perfusion techniques have allowed for preserved perfusion to the brain during arch repair. Current techniques have further evolved that allow for continuous perfusion of the heart and even the lower body during arch reconstruction. With current techniques, aortic arch reconstruction in infants can be performed with continuous perfusion to the brain, heart, and lower body. Further technical refinements will be helpful, and study is necessary to evaluate the benefit of these strategies.