Neurodevelopmental outcomes after infant cardiac surgery with circulatory arrest and intermittent perfusion.

Background: Optimal perfusion strategies for neuroprotection during infant cardiac surgery remain undefined. Despite encouraging experimental data, neurodevelopmental (ND) outcomes after cardiac surgery in neonates and infants using deep hypothermic circulatory arrest (DHCA) with a period of intermittent perfusion have not been reported, and it is not known whether DHCA can be extended while preserving ND outcomes.

Methods: Cross-sectional ND evaluation with the Bayley Scales of Infant and Toddler Development, Third Edition was conducted at 24 months of age.

Aristotle score predicts outcome in patients requiring extracorporeal circulatory support following repair of congenital heart disease.

Extracorporeal membrane oxygenation (ECMO) has become the standard technique of mechanical support for the failing circulation following repair of congenital heart lesions. The objective of this study was to identify predictors of survival in patients requiring postcardiotomy ECMO. The Aristotle score, a method developed to evaluate quality of care based on complexity, was investigated as a potential predictor of outcome.

Modified CPB circuit for postoperative rescue of high-risk patients following cardiac repair: are we keeping safe?

Extracorporeal membrane oxygenation (ECMO) is commonly used to treat postcardiotomy cardiopulmonary dysfunction in small children. System readiness, need for additional blood products, and exposure to new surfaces are important considerations, particularly when used for resuscitation. We reviewed our experience with a cardiopulmonary bypass (CPB) system modified to provide extended circulatory support system after surgery in patients considered at high risk.

Is there a role for extracorporeal life support after stage I Norwood?

Objectives: Controversy still surrounds the use of extracorporeal life support (ECLS) in patients with single ventricle physiology. An analysis of the experience with a group of neonates who underwent stage I Norwood palliation and received ECLS is reported.

Methods: A retrospective review of hospital records, operative notes and perfusion data was performed in a group of 12 consecutive patients undergoing ECLS in the perioperative period after stage I.