Revista Brasileira de Cirurgia Cardiovascular
On-line version ISSN 1678-9741
GIFFHORN, Hélcio et al. Parada circulatória total em cirurgia cardíaca pediátrica: relato de 130 casos. Rev Bras Cir Cardiovasc [online]. 1998, vol.13, n.1, pp. 42-47. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76381998000100008.
Deep hypothermic circulatory arrest (DHCA) increased the number of pediatric patients operated on our Service and it is an important aid for the correction of complex cardiovascular procedures. We studied 130 patients from January, 1995 to June, 1996. Patient ages ranged from 2 days to 16 years. The most frequent pathology was VSD (26%), tetralogy of Fallot (13%), TGA (10%) and AVSD (10%). All patients used membrane oxygenators, rectal temperature was maintained at a mean of 15,4°C. Mean perfusion time was 45 minutes. In the early postoperatory stage, low output was the most frequent complication (49 - 38%). Neurological changes occured in 27 patients (20%): 13 seizures (10%), 8 neuropsychologic disfunction (6.1%), 5 extrapyramidal signs (3,8%), 4 neuro-ophthalmic deficits (3%), 4 comas. 5 of these symptoms appeared early in the postoperative period and could be attributed to DHCA (3.8%). There were 20 (15%) deaths. 3 had a permanent neurologic deficit on discharge (2 dysartrias and 1 muscular hypertonya). We concluded that DHCA is useful for the correction of complex cardiac anomalies with a low risk of neurologic complications permanent. Our late follow up is too short for precise analysis of psycomotor development in these patients.
Keywords : Heart defects [congenital, surgery]; Hypothermia, induced [methods]; Heart arrest, induced [methods]; Postoperative complications; Neurologic manifestations.