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Antegrade regional cerebral perfusion

Published online by Cambridge University Press:  21 September 2005

Christo I. Tchervenkov ,
Abdulaziz Al-Khaldi  and
Dominique Shum-Tim
Christo I. Tchervenkov
Affiliation:
The Division of Cardiovascular Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Canada
Abdulaziz Al-Khaldi
Affiliation:
The Division of Cardiovascular Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Canada
Dominique Shum-Tim
Affiliation:
The Division of Cardiovascular Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Canada
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Extract

A quiet and bloodless field providing optimal surgical conditions has been a crucial prerequisite for the performance of complex cardiac repairs in early life. The use of deep hypothermic circulatory arrest has fulfilled this role, and has been a catalyst for the development of neonatal and infant cardiac surgery. The recently increased awareness of possibly increased incidence of adverse neurological events and developmental outcome associated with this technique,1–5 however, has led to a general trend away from its use. In its place, techniques have been developed to provide cerebral perfusion during reconstruction of the aortic arch and the Norwood operation. Some have described the techniques as regional low-flow perfusion. In our opinion, they are described more accurately as antegrade regional cerebral perfusion. In this review, we discuss the recently described techniques for such antegrade regional cerebral perfusion during surgery on the aortic arch, with emphasis both on the Norwood operation and the observed physiological changes in the cerebral and systemic circulations. The neurologic and developmental outcomes following the use of the technique are still unknown.

Type
Norwood Procedure and Staged Palliation
Information
Cardiology in the Young , Volume 14 , Issue S1 , February 2004 , pp. 70 - 74
Copyright
© 2004 Cambridge University Press

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