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Clinical neurologic and developmental studies after cardiac surgery utilizing hypothermic circulatory arrest and cardiopulmonary bypass

Published online by Cambridge University Press:  19 August 2008

Gil Wernovsky ,
Richard A. Jonas ,
Paul R. Hickey ,
Adré J. du Plessis  and
Jane W. Newburger
Gil Wernovsky*
Affiliation:
From the Departments of Cardiology, Cardiac Surgery, Anesthesiology and Neurology, Children's Hospital and the Departments of Pediatrics, Surgery, Anesthesiology and Neurology, Harvard Medical School, Boston
Richard A. Jonas
Affiliation:
From the Departments of Cardiology, Cardiac Surgery, Anesthesiology and Neurology, Children's Hospital and the Departments of Pediatrics, Surgery, Anesthesiology and Neurology, Harvard Medical School, Boston
Paul R. Hickey
Affiliation:
From the Departments of Cardiology, Cardiac Surgery, Anesthesiology and Neurology, Children's Hospital and the Departments of Pediatrics, Surgery, Anesthesiology and Neurology, Harvard Medical School, Boston
Adré J. du Plessis
Affiliation:
From the Departments of Cardiology, Cardiac Surgery, Anesthesiology and Neurology, Children's Hospital and the Departments of Pediatrics, Surgery, Anesthesiology and Neurology, Harvard Medical School, Boston
Jane W. Newburger
Affiliation:
From the Departments of Cardiology, Cardiac Surgery, Anesthesiology and Neurology, Children's Hospital and the Departments of Pediatrics, Surgery, Anesthesiology and Neurology, Harvard Medical School, Boston
*
Dr. Gil Wernovsky, Cardiac Intensive Care Unit, Farley 653, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Tel. (617) 735-7866; Fax. (617) 730-0403.
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Extract

The dramatic reduction in surgical mortality associated with repair of congenital heart anomalies in recent decades has been accompanied by a growing recognition of adverse neurologic sequels in some of the survivors. Abnormalities of the central nervous system may be a function of coexisting cerebral abnormalities or acquired events unrelated to surgical management (such as paradoxical embolus, cerebral infection, or effects of chronic cyanosis), but insults to the central nervous system appear to occur most frequently during or immediately after surgery. In particular, techniques of support used during neonatal and infant cardiac surgery—cardiopulmonary bypass, profound hypothermia and circulatory arrest—have been implicated as important causes of cerebral injury. This paper will review the effects of bypass and deep hypothermic circulatory arrest on neurodevelopmental outcome.

Keywords

Management of bypassintelligence quotientelectroencephalographycore cooling
Type
World Forum for Pediatric Cardiology Symposium on Cardiopulmonary Bypass (Part 1)
Information
Cardiology in the Young , Volume 3 , Issue 3 , July 1993 , pp. 308 - 316
Copyright
Copyright © Cambridge University Press 1993

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