Avoiding use of total circulatory arrest in the practice of congenital heart surgery
| Autor: | Sudeep Verma, Anil Kumar Dharmapuram, Nagarajan Ramadoss, Vejendla Goutami |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic arch medicine.medical_specialty business.industry Review Article 030204 cardiovascular system & hematology Vascular surgery law.invention Surgery Cardiac surgery 03 medical and health sciences 0302 clinical medicine 030228 respiratory system law Cardiothoracic surgery medicine.artery Circulatory system Cardiopulmonary bypass Deep hypothermic circulatory arrest Medicine Cerebral perfusion pressure Cardiology and Cardiovascular Medicine business |
| Zdroj: | Indian J Thorac Cardiovasc Surg |
| ISSN: | 0973-7723 0970-9134 |
| DOI: | 10.1007/s12055-020-00955-8 |
| Popis: | Deep hypothermic circulatory arrest (DHCA) technique has been an important armamentarium in the correction of congenital heart diseases. There have been many controversies and concerns associated with DHCA, particularly neurological damage. Selective ante grade cerebral perfusion (SACP) was introduced as an adjunct to DHCA with the objective of limiting the neurologic injury during aortic arch repairs. Over the past two decades, various aspects of cardiopulmonary bypass and DHCA have been studied and modified such as optimisation of flows, anti-inflammatory interventions, haematocrit, and temperature to improve neurologic outcomes. With the changes in practice of DHCA, outcomes have significantly improved but SACP intuitively appears attractive to offer better neuroprotection. The strategy of conduct of SACP is evolving and needs to be standardised for comparing outcomes. In this review we have discussed the various physiological and technical factors involved in conduct of SACP in paediatric cardiac surgery and outcomes with SACP. |
| Databáze: | OpenAIRE |
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