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Ann Thorac Surg 1996;61:779-780
© 1996 The Society of Thoracic Surgeons

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Editorials

Deep Hypothermic Circulatory Arrest: A Need for Caution

Department of Cardiac Surgery, Children's Hospital, Boston, Massachusetts

The first 20% of the full text of this article appears below.

In this edition of The Annals Eke and colleagues [1] have addressed the important issue of the possible deleterious neurologic effects of deep hypothermic circulatory arrest. This is a courageous study in that the patient population is predominantly patients with hypoplastic left heart syndrome who underwent cardiac transplantation in the first months of life. These patients frequently suffer profound metabolic insults before diagnosis and often must be maintained in the intensive care unit for long periods of time in a parlous state while waiting for an appropriate donor. Eke and colleagues have concluded from their study that neither the duration of circulatory arrest nor the rate of cooling to achieve deep hypothermia influences subsequent developmental outcome. These conclusions have very important implications for the conduct of surgical procedures for children with congenital heart disease and warrant careful examination.

See also page 783.

Eke and colleagues used the Bayley scales of infant development to study retrospectively a small group of 38 infants who had undergone cardiac transplantation using a relatively uniform protocol of deep hypothermic circulatory arrest. They found a mean mental development score (a precursor measure of cognitive ability) of 88. Recent normative data suggest that the mean score for children without heart disease is 112. A score of 80 to . . . [Full Text of this Article]

Related Article

Neurologic Sequelae of Deep Hypothermic Circulatory Arrest in Cardiac Transplant Infants

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]

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