Combined use of surface and perfusion hypothermia in intracardiac surgery in infants under one year of age.

Deep hypothermia has recently gained popularity as an adjunct to intracardiac surgery for neonates and infants. A number of Japanese investigators played a role in the development and clinical application of both simple surface-induced hypothermia and the combined use of surface and perfusion cooling. The developmental history of both methods is described in detail. At the Heart Institute of Japan, 71 infants under one year of age underwent intracardiac surgery over the past six years. There has been a notable decrease in operative mortality since the employment of circulatory arrest under deep hypothermia and limited pump-perfusion. This trend is marked in infants with ventricular septal defect and pulmonary hypertension, and in those with total anomalous pulmonary venous connection. The Landé-Edwards membrane oxygenator proved helpful in prevention of postoperative pulmonary complications.