Impact of Whole-Body Perfusion in Postoperative Outcomes After Aortic Arch Reconstruction Surgery in Neonates and Infants

Authors

  • Rodrigo Sandoval Boburg, MD Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
  • Charlotte Faust, MD Department of Anaesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
  • Tobias Kruger, MD Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
  • Migdat Mustafi, MD Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
  • Harry Magunia, MD Department of Anaesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
  • Felix Neunhoeffer, MD Department of Pediatric Cardiology and Intensive Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
  • Michael Hofbeck, MD, PhD Department of Pediatric Cardiology and Intensive Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
  • Christian Schlensak, MD, PhD Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany

DOI:

https://doi.org/10.1532/hsf.4501

Keywords:

congenital heart surgery, organ protection, neonatal surgery, femoral cannulation, mechanical circulatory support

Abstract

Introduction: The aim of this study was to determine whether whole-body perfusion (WBP) consisting of a combined antegrade cerebral perfusion (ACP) and lower body perfusion (LBP) improves the outcome after aortic arch reconstruction surgery in neonates compared with ACP.

Methods: Sixty-five consecutive patients under one year of age who underwent aortic arch reconstruction as the main procedure or as part of a more complex surgery from 2014-2020 in our center were included. The patients were separated into two groups, according to the perfusion strategy, either ACP (34 patients) as the control group or WBP (31 patients) as the intervention group. LBP was achieved through an arterial sheath in the femoral artery. Outcome parameters were postoperative renal, gastrointestinal, and neurological complications and 30-day mortality.

Results: The patients in the WBP group showed lower intraoperative lactate levels and close to normal early postoperative renal and hepatic enzymes and LDH at PICU admission compared with the patients in the ACP group. The number of patients suffering from postoperative neurological complications and multiorgan failure was lower in the WBP group.

Conclusion: In our experience, the combined use of ACP and LBP through the femoral artery showed an improvement, regarding postoperative neurologic complications in neonates and infants undergoing aortic arch surgery.

References

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Published

2022-03-24

How to Cite

Sandoval, R., Faust, C., Kruger, T., Mustafi, M., Magunia, H., Neunhoeffer, F., Hofbeck, M., & Schlensak, C. (2022). Impact of Whole-Body Perfusion in Postoperative Outcomes After Aortic Arch Reconstruction Surgery in Neonates and Infants. The Heart Surgery Forum, 25(2), E222-E228. https://doi.org/10.1532/hsf.4501

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