One-stage repair of interrupted aortic arch with selective cerebral perfusion

To minimize the neurological compromise after the circulatory arrest, the selective cerebral perfusion could be beneficial. We underwent one-stage repair of the interrupted aortic arch (IAA) with various intracardiac anomalies for the six patients, age ranging from 12 days to 4 months, by using the selective cerebral perfusion. Cardiopulmonary bypass was established by using two-way arterial cannulation supported by the two respective pump systems, one of which utilized the EPTFE graft anastmosed to either the bracheocephalic artery or the right subclavian artery and second of which enrouted through the arterial ductus to the descending aorta. The cerebral perfusion during the circulatory arrest for the aortic arch repair was maintained by the selective perfusion via EPTFE graft with 10 ml/kg/min blood flow. After the completion of the arch repair, the total system perfusion was restarted through the graft and the repair of the intracardiac anomalies was followed. Of six, no operative death or neurological complications related to the operation were found. The clinical neurological evaluation after operation also demonstrated the normal for the age. In conclusion, the selective cerebral perfusion by using the EPTFE graft during the circulatory arrest might decrease the risk of brain damage.