Ann Thorac Surg 1996;61:787-788
© 1996 The Society of Thoracic Surgeons
Discussion
Discussion
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See also page 783.
DR KEVIN TURLEY (San Francisco, CA): I congratulate the Loma Linda group for this very provocative study. The findings fly in the face of much of the contemporary wisdom concerning deep hypothermia and circulatory arrest and must be looked at in the context of the historical development of these techniques in the neonate. Deep hypothermia and total circulatory arrest was developed because of the high mortality associated with standard bypass techniques almost a quarter of a century ago. It was found that over the subsequent years, bypass techniques improved, and it became clear that with surfaced-induced deep hypothermic techniques, some neurologic problems were evident. With the improvement in standard bypass techniques, circulatory arrest was performed less and less; however, in a group of patients like the one just discussed, this technique has many advantages. It gives a bloodless view without large cannulas to afford a quick, precise operative intervention, such as Dr Bailey's group has described, with very acceptable time limits.
The data presented here have to be looked at in the context of the events of the cooling phase. Time of circulatory arrest and time of cooling are important indices of the events that are happening, and clearly, method of cooling, specifically, the perfusate as presented here, influences the evenness of cooling and the delivery of the cold perfusate to both distal tissues and brain. . . . [Full Text of this Article]
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- Clifford C. Eke, Steven R. Gundry, Marti F. Baum, Richard E. Chinnock, Anees J. Razzouk, and Leonard L. Bailey
Ann. Thorac. Surg. 1996 61: 783-787.
[Abstract]
[Full Text]
Copyright © 1996 by The Society of Thoracic Surgeons.
