Virtual Conference
Heart Conference

Efimochkin Georgii

Scientific Research Institute – S. V. Ochapovsky Regional Clinical Hospital, Russian Federation

Title: The use of antegrade cerebral perfusion during arterial switch with aortic arch obstruction

Abstract

Introduction: The combination of obstruction of the aortic arch and complex congenital heart defects is quite common. Correction with deep hypothermia and circulatory arrest was generally accepted, however, the development of antegrade cerebral perfusion techniques showed an improvement in the results of surgical correction of this category of patients, leveling the negative consequences of deep hypothermia and circulatory arrest. This report presents our experience of simultaneous correction of transposition of the great arteries and aortic arch obstruction with antegrade cerebral perfusion.

Material and methods: During the period from 2014 to December 2021, 10 patients with transposition of the great arteries in combination with aortic arch obstruction were operated on. Of these, 8 patients were with TMA and ventricular septal defect, 2 - with Taussig–Bing anomaly. Aortic arch anomalies included aortic coarctation with aortic arch hypoplasia (n = 80%) and interruption aortic arch (n = 20%).

Results: In the immediate postoperative period, 1 patient died, there were no long-term fatal outcomes. With the use of antegrade cerebral perfusion, we did not receive neurological complications, and moderate hypothermia allowed us to avoid capillary leakage and the development of multiple organ failure syndrome.

Conclusions: In patients with a combination of transposition of the great arteries and aortic arch obstruction, a one-stage correction in the neonatal period is indicated. Preservation of antegrade cerebral perfusion reduces the risk of cognitive and psychomotor deficits, and moderate hypothermia avoids systemic inflammatory response syndrome, capillary leakage and multiple organ failure syndrome.

Biography

Efimochkin Georgii completed his Cand.Sc. at the age of 45 years from Scientific Research Institute – S. V. Ochapovsky Regional Clinical Hospital ?1, Russian Federation. He has over 20 publications, his publication h-index is 1. He has one patent for invention.