The Journal of Thoracic and Cardiovascular Surgery
Volume 133, Issue 4 , Pages 880-887.e1 , April 2007

A randomized clinical trial of regional cerebral perfusion versus deep hypothermic circulatory arrest: Outcomes for infants with functional single ventricle

Read at the Eighty-sixth Annual Meeting of The American Association for Thoracic Surgery, Philadelphia, Pa, April 29-May 3, 2006.

  • Caren S. Goldberg, MD

      Affiliations

    • Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich
    • Corresponding Author InformationAddress for reprints: Caren S. Goldberg, MD, C.S. Mott Children’s Hospital, L1221 Women’s Box 0204, 1500 East Medical Center Dr, Ann Arbor, MI 48109-0204.
    • ,
  • Edward L. Bove, MD

      Affiliations

    • Section of Cardiac Surgery, University of Michigan, Ann Arbor, Mich
    • ,
  • Eric J. Devaney, MD

      Affiliations

    • Section of Cardiac Surgery, University of Michigan, Ann Arbor, Mich
    • ,
  • Eileen Mollen, PhD

      Affiliations

    • Division of Pediatric Psychology, University of Michigan, Ann Arbor, Mich
    • ,
  • Edward Schwartz, PhD

      Affiliations

    • Division of Pediatric Psychology, University of Michigan, Ann Arbor, Mich
    • ,
  • Shauna Tindall, PhD

      Affiliations

    • Division of Pediatric Psychology, University of Michigan, Ann Arbor, Mich
    • ,
  • Cheryl Nowak, RN

      Affiliations

    • Section of Cardiac Surgery, University of Michigan, Ann Arbor, Mich
    • ,
  • John Charpie, MD

      Affiliations

    • Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich
    • ,
  • Morton B. Brown, PhD

      Affiliations

    • School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, Mich.
    • ,
  • Tom J. Kulik, MD

      Affiliations

    • Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich
    • ,
  • Richard G. Ohye, MD

      Affiliations

    • Section of Cardiac Surgery, University of Michigan, Ann Arbor, Mich

Received 20 June 2006 ,Revised 8 November 2006 ,Accepted 20 November 2006.

References 

  1. Mahle WT, Spray TL, Wernovsky G, Gaynor JW, Clark BJ. Survival after reconstructive surgery for hypoplastic left heart syndrome: a 15 year experience from a single institution. Circulation. 2000;102(19 suppl 3):III136–III141
  2. Bove EL, Lloyd TR. Staged reconstruction for hypoplastic left heart syndrome (Contemporary results). Ann Surg. 1996;224:387–394
  3. Tweddell JS, Hoffman GM, Mussatto KA, Fedderly RT, Berger S, Jaquiss RD, et al. Improved survival of patients undergoing palliation of hypoplastic left heart syndrome: lessons learned from 115 consecutive patients. Circulation. 2002;106(suppl I):I82–I89
  4. Kern JH, Hayes JH, Michler RE, Gersony WM, Quagebeur JM. Survival and risk factor analysis for the Norwood procedure for hypoplastic left heart syndrome. Am J Cardiol. 1997;80:170–174
  5. Goldberg CS, Schwartz EM, Brunberg JA, Mosca RS, Bove EL, Schork MA, et al. Neurodevelopmental outcome of patients after the Fontan operation: a comparison between children with hypoplastic left heart syndrome and other functional single ventricle lesions. J Pediatr. 2000;137:646–652
  6. Mahle WT, Clancy RR, Moss EM, Gerdes M, Jobes DR, Wernovsky G. Neurodevelopmental outcome and lifestyle assessment in school-aged and adolescent children with hypoplastic left heart syndrome. Pediatrics. 2000;105:1082–1089
  7. Kern JH, Hinton VJ, Nereo NE, Hayes CJ, Gersony WM. Early developmental outcome after the Norwood procedure for hypoplastic left heart syndrome. Pediatrics. 1998;102:1148–1152
  8. Wernovsky G, Stiles KM, Gauvreau K, Gentles TL, duPlessis AJ, Bellinger DC, et al. Cognitive development after the Fontan operation. Circulation. 2000;102:883–889
  9. Uzark K, Lincoln A, Lamberti JJ, Mainwaring RD, Spicer RL, Moore JW. Neurdevelopmental outcomes in children with Fontan repair of functional single ventricle. Pediatrics. 1998;101:630–633
  10. Oates RK, Simpson JM, Turnbull JAB, Cartmill TB. The relationship between intelligence and duration of circulatory arrest with deep hypothermia. J Thorac Cardiovasc Surg. 1995;110:786–792
  11. Newburger JW, Jonas RA, Wernovsky G, Wypij D, Hickey PR, Kuban KC, et al. A comparison of perioperative neurologic effects of hypothermic circulatory arrest versus low flow cardiopulmonary bypass in infant heart surgery. N Engl J Med. 1993;329:1057–1064
  12. Bellinger DC, Wypij D, Kuban KC, Rappaport LA, Hickey PR, Wernovsky G, et al. Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation. 1999;100:526–532
  13. Pigula FA, Nemoto EM, Griffith BP, Siewers RD. Regional low-flow perfusion provides cerebral circulatory support during neonatal aortic arch reconstruction. J Thorac Cardiovasc Surg. 2000;119:331–339
  14. Asou T, Kado H, Imoto Y, Shiokawa Y, Tominaga R, Kawachi Y, et al. Selective cerebral perfusion technique during aortic arch repair in neonates. Ann Thorac Surg. 1996;61:1546–1548
  15. Tchervenkov CI, Chu VF, Shum-Tim D, Laliberte E, Reyes TU. Norwood operation without circulatory arrest: a new surgical technique. Ann Thorac Surg. 2000;70:1730–1733
  16. Bove EL. Current status of staged reconstruction for hypoplastic left heart syndrome. Pediatr Cardiol. 1998;19:308–315
  17. Bayley N. Bayley Scales of Infant Development. 2nd ed.. San Antonio: Pychological Corp; 1993;
  18. Myung RJ, Petko M, Judkins AR, Schears G, Ittenbach RF, Waibel RJ, et al. Regioanl low-flow perfusion improves neurologic outcome compared with deep hypothermic circulatory arrest in neonatal piglets. J Thorac Cardiovasc Surg. 2004;127:1051–1057
  19. Dent CL, Spaeth JP, Jones BV, Schwartz SM, Glauser TA, Hallinan B, et al. Brain magnetic resonance imaging abnormalities after the Norwood procedure using regional cerebral perfusion. J Thorac Cardiovasc Surg. 2006;131:190–197
  20. Wypij D, Newburger JW, Rappaport LA, duPlessis AJ, Jonas RA, Wernovsky G, et al. The effect of duration of deep hypothermic circulatory arrest in infant heart surgery on late neurodevelopment: the Boston Circulatory Arrest Trial. J Thorac Cardiovasc Surg. 2003;126:1397–1403
  21. Mahle WT, Clancy RR, McGaurn SP, Goin JE, Clark BJ. Impact of prenatal diagnosis on survival and early neurologic morbidity in neonates with hypoplastic left heart syndrome. Pediatrics. 2001;107:1277–1282
  22. Gaynor JW, Gerdes M, Zackai EH, Bernbaum J, Wernovsky G, Clancy RR, et al. Apolipoprotein E genotype and neurodevelopmental sequelae of infant cardiac surgery. J Thorac Cardiovasc Surg. 2003;126:1736–1745
  23. Jonas RA, Wypij D, Roth SJ, Bellinger DC, Visconti KJ, du Plessis AJ, et al. The influence of hemodilution on outcome after hypothermic cardiopulmonary bypass: results of a randomized trial in infants. J Thorac Cardiovasc Surg. 2003;126:1765–1774

 Funded by the Doris Duke Charitable Foundation, University of Michigan General Clinical Research Center.

PII: S0022-5223(06)02180-5

doi: 10.1016/j.jtcvs.2006.11.029

The Journal of Thoracic and Cardiovascular Surgery
Volume 133, Issue 4 , Pages 880-887.e1 , April 2007

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