Heart transplantation for hypoplastic left heart syndrome: modified technique for reducing circulatory arrest time.

BACKGROUND

The surgical technique of heart transplantation as therapy in infants with hypoplastic left heart syndrome was first reported over a decade ago. Since that time, incremental refinements have evolved that both facilitate the operation and potentially reduce the perceived neurologic hazards associated with the use of hypothermic circulatory arrest.

METHODS

Minor technical adjustments have permitted infant heart transplantation to be accomplished with relative ease while markedly limiting the need for complete circulatory arrest. Low-flow hypothermic systemic perfusion is used for atrial implantation, reserving circulatory arrest for arch reconstruction only. This is accomplished by use of an active (pump) sucker for venous return.

RESULT: Mean circulatory arrest time with the current technique has been 26 minutes.

CONCLUSION

Minor technical refinements have resulted in a marked reduction in hypothermic circulatory arrest time during infant heart transplantation for hypoplastic left heart syndrome.