Norwood Reconstruction Using Continuous Coronary Perfusion: A Safe and Translatable Technique

Turek, Joseph W.; Hanfland, Robert A.; Davenport, Tina L.; Torres, José E.; Duffey, David A.; Patel, Sonali S.; Reinking, Benjamin E.; Poston, Patrick M.; Davis, James E.

doi:10.1016/j.athoracsur.2013.03.049

Cited by 32 publications

(41 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall hospital morbidity in the present study was in line with prior observations on neonatal arch repair, when not lower . Furthermore, cardiac morbidity was significantly lower in patients having selective CMP.…”

Section: Discussionsupporting

confidence: 91%

“…Prior studies showed the feasibility and safety of combining ACP with myocardial perfusion with the goal of reducing, when not avoiding at all, the duration of myocardial ischemia in a variety of pediatric cardiac surgical scenarios . More recently, an alternative and novel strategy for selective cerebro‐myocardial protection was developed, where ACP is associated with controlled and independent coronary perfusion .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Selective versus standard cerebro‐myocardial perfusion in neonates undergoing aortic arch repair: A multi‐center study

et al. 2019

View full text Add to dashboard Cite

The results of neonatal aortic arch surgery using cerebro‐myocardial perfusion were analyzed. Selective cerebral and myocardial perfusion, using two separate pump rotors, was compared with standard perfusion, using a single pump rotor with an arterial line Y‐connector. Between May 2008 and May 2016, 69 consecutive neonates underwent arch repair using either selective cerebro‐myocardial perfusion (Group A, n = 34) or standard perfusion (Group B, n = 35). The groups were similar for age, weight, BSA, prevalence of one‐stage or staged repair, and single ventricle palliation; male gender was more frequent in Group A. The duration of the cerebro‐myocardial perfusion was comparable (27 ± 8 vs. 28 ± 7 min, P = 0.9), with higher flows in Group A (57 ± 27 vs. 39 ± 19 mL/kg/min, P = 0.01). Although cardioplegic arrest was more common in Group B (13/34 vs. 23/35, P = 0.03), the duration of myocardial ischemia was longer in Group A (64 ± 41 vs. 44 ± 14 min, P = 0.04). There was 1 hospital death in each group, with no permanent neurological injury in either group. Cardiac morbidity (1/34 vs. 7/35, P = 0.02) was more common in Group B, while extracardiac morbidity was similar in both the groups. During follow‐up (3.2 ± 2.4 years), 5 late deaths occurred with a comparable 5‐year survival rate (75 ± 17% vs. 88 ± 6%, P = 0.7) and freedom from arch reintervention (86 ± 6% vs. 84 ± 7%, P = 0.6). Risk of cardiac morbidity was greater with standard cerebro‐myocardial perfusion (OR = 5.2, CI 3.3–6.8, P = 0.001) and with perfusion flows less than 50 mL/kg/min (OR 3.7, CI 1.87–5.95, P = 0.04). Cerebro‐myocardial perfusion is a safe and effective strategy to protect the brain and heart in neonates undergoing arch repair. Selective techniques using higher perfusion flows may further attenuate cardiac morbidity.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Selective versus standard cerebro‐myocardial perfusion in neonates undergoing aortic arch repair: A multi‐center study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Since then, several modifications have been described [5,6], including the use of continuous coronary flow using a cardioplesia spike or an olivetip cannula secured in the proximal ascending aorta [6]; the authors reported that this modification was a safe alternative for use with any size of aorta. For smaller ascending aortic diameters, an olive-tip cannula connected to the arterial circuit can be placed into the lumen of the opened aorta and secured with a vessel loop tourniquet.…”

Section: Commentmentioning

confidence: 98%

Beating-Heart Surgery for Hypoplastic Left Heart Syndrome With Coronary Artery Fistulas

Matsushima

Oshima

Maruo

et al. 2014

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

“…Other regional perfusion strategies have been descri bed, which limit whole body or myocardial and/or splanchnic circulatory arrest times [98][99][100]. Regional cerebral and coronary circulation (RCCP) has an RCP-type arterial cannulation but differs in that the right brachiocephalic vessel is not controlled during part of the arch repair.…”

Section: Flow Ratesmentioning

confidence: 99%

The bypass plan

Matte

2015

Perfusion for Congenital Heart Surgery

View full text Add to dashboard Cite

The perfusionist must be familiar with the patient's original diagnosis, catheterization lab interventions, previous surgeries, and current needs when developing the bypass plan. The following are major considerations for management of the patient during cardiopulmonary bypass. Please refer to Chapter 6 for defect-specific considerations.The care team must have a reasonably standardized communication plan for the bypass run [1][2][3]. This includes standardizing to closed-loop communication for certain anesthesia, surgical, and cardiopulmonary bypass (CPB) commands, notifications, and/or concerns. Each communication should be verbally acknowledged per the team standard (either repeated back or with another affirmation) to ensure the information is properly delivered and handled. This technique is essential for bypass safety and is used at most centers to announce checkpoints during the case.Common bypass-related checkpoints where closedloop communication among the team is essential include the following: • Heparin in • ACT running • Bypass lines clamped and ready for division at the field • Pump suckers on (with suckers and vent line tested under saline at field)

show abstract

Norwood Reconstruction Using Continuous Coronary Perfusion: A Safe and Translatable Technique

Cited by 32 publications

References 9 publications

Selective versus standard cerebro‐myocardial perfusion in neonates undergoing aortic arch repair: A multi‐center study

Selective versus standard cerebro‐myocardial perfusion in neonates undergoing aortic arch repair: A multi‐center study

Beating-Heart Surgery for Hypoplastic Left Heart Syndrome With Coronary Artery Fistulas

The bypass plan

Contact Info

Product

Resources

About