Evaluation of safety of selective cerebral perfusion when reconstructing aortic arch in infants

Objective. The purpose of our research was to assess the safety of antegrade selective cerebral perfusion and moderate hypothermy during aortic arch reconstruction in children of different age groups. Methods. 25 patients with aortic arch obstruction were operated at the institute. The patients were divided in 2 groups; group I consisted of 13 patients under 1 year, group II included 12 patients over 1 year. Aortic arch reconstruction under antegrade selective cerebral perfusion and moderate hypothermy was performed in all patients. To assess the adequacy of perfusion, all patients underwent venous blood sampling from the upper and lower vena cava at different stages of intervention. Results. No fatal outcomes, neurological or renal complications were observed in this series of operations. According to the data obtained by near-infrared spectroscopy sensors from the brain, no drop in saturation below 40% was recorded during the entire aortic arch reconstruction. Subsequent analysis of venous blood saturation from the vena cava revealed a significant difference between the two groups among the samples of the inferior vena cava in the second and third blood sampling, while 40% reduction of saturation was noted in only 6 patients of Group II. Conclusion. The temperature conditions used and antegrade selective perfusion flow rate enable us to effectively protect the organs during intervention on the aortic arch in children of different age groups.