A cardiopulmonary bypass strategy to support a patient with vein of Galen malformation

Abstract

We present a dissection of the patent ductus arteriosus and pulmonary artery for surgical repair utilising cardiopulmonary bypass in the setting of vein of Galen malformation. Several strategies were employed to attenuate the cerebral shunt including pH-stat, high cardiac index, restrictive venous drainage, continuous ventilation and deep hypothermic circulatory arrest. The patient recovered from surgery with no apparent neurological sequelae.

Vein of Galen malformation and cardiopulmonary bypass

“…The Boston Children’s Hospital perfusion team read, A cardiopulmonary bypass strategy to support a patient with vein of Galen malformation , by Robertson, Muthialu and Broadhead with great interest. 1 This case report came on the heels of our program recently utilizing cardiopulmonary bypass (CPB) on two cardiac surgery patients with the same vascular malformation. As with the Robertson report, we used hypothermia, pH-stat blood gas management and high-flow bypass as strategies to help ensure perfusion to the brain and body during bypass.…”