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Ann Thorac Surg 1990;49:970-972
© 1990 The Society of Thoracic Surgeons

Articles

Isolated myocardial perfusion during arch repair

Shunji Sano, MD, PhD, Roger B.B. Mee, FRACS*

Department of Csrdiac Surgery, Royal Children's Hospital, Melbourne, Australia

Accepted for publication January 10, 1990.

* Address correspondence to Dr Mee, Victorian Paediatric Cardiac Surgical Unit, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, Australia 3052.

Repair of coarctation of the aorta with severe hypoplasia of the aortic arch or interrupted aortic arch was performed in 5 patients using a modification of the usual technique that consisted of isolated myocardial perfusion during arch repair. The aortic cross-clamp was placed on the ascending aorta distal to the aortic cannula. Cardiopulmonary bypass flow was reduced to about 10% of full flow, achieving a line pressure of 35 to 45 mm Hg to keep the heart perfused and beating during arch repair. Once the aortic arch was repaired, total body perfusion was continued as usual and intracardiac repair was performed. Isolated myocardial perfusion for aortic arch reconstruction reduces myocardial ischemic time.




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