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Selective Cerebral Perfusion Technique During Aortic Arch Repair in Neonates

We describe selective cerebral perfusion techniques for repair of the aortic arch in neonates. These techniques may help protect the brain from ischemic injury caused by a cessation of cerebral perfusion for aortic arch reconstruction in patients with hypoplastic left heart syndrome or interrupted aortic arch.
Although hypothermic circulatory arrest has been  a widely used procedure for the surgical repair of
arch anomalies in neonates and infants, it has been suggested that this procedure sometimes produces neurologic injury. Because the long-term outcomes of cerebral function such as intellectual function and development after hypothermic circulatory arrest still remain to be determined, it seems worthwhile to protect the brain from ischemic injury as much as possible in neonatal open heart operations. We herein present some selective cerebral perfusion techniques in which the cerebral blood flow can be better maintained during the reconstruction of the aortic arch in the Norwood operation for neonates with hypoplastic left heart syndrome.
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