Beating Heart Versus Cardiac Arrest in Isolated Aortic Arch Reconstruction: A Comparative Study in Neonates and Infants
Journal of Cardiac Surgery, cilt.2025, sa.1, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 2025 Sayı: 1
- Basım Tarihi: 2025
- Doi Numarası: 10.1155/jocs/3445014
- Dergi Adı: Journal of Cardiac Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE
- Anahtar Kelimeler: arch reconstruction, beating heart, congenital heart disease, coronary perfusion
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: Surgical treatment of aortic arch hypoplasia includes differences in terms of perfusion strategies. We aimed to compare the early and midterm results of isolated aortic arch reconstruction in terms of operation on antegrade cerebral perfusion (ACP) with beating heart (BH) or ACP with cardiac arrest (CA). Methods: Medical records of 72 patients undergoing isolated aortic arch reconstruction from October 2020 to April 2024 were retrospectively reviewed. The patients were divided into two groups: Group 1 (34 patients) underwent arch reconstruction on BH and Group 2 (38 patients) underwent arch reconstruction with CA. All arch repair procedures were performed with the patch augmentation technique. Results: The median age at surgery was 13 (interquartile range (IQR), 7–39.2) days and the median weight was 3.3 (IQR, 2.8–4) kg. Fifty-two patients (72.2%) were neonates and 20 (27.8%) were infants. Postoperative early mortality rate was 1.39% (1/34 vs. 0/38, p = 0.28). There was no statistically significant difference between two groups in terms of delayed sternal closure, intensive care unit (ICU) and hospital stays (p = 0.78, 0.54, and 0.7). Fifteen (20.8%) of the patients were extubated on the table, and fast-track extubation rate was significantly higher in the BH group (11/34 vs. 4/38, p = 0.023). The median duration of follow-up was 7.2 (IQR, 1–18.2) months and there was no late death in either group. The incidence of restenosis and reintervention was not statistically significant between the two groups (1/34 vs. 1/38, p = 0.91). Conclusion: Both perfusion strategies were associated with satisfactory early and midterm results. Although the length of stay in the ICU and hospital were not significantly different for both groups, the fast-track extubation rate was significantly higher in the BH group.