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Review
. 2020 Mar;12(3):1235-1259.
doi: 10.21037/jtd.2019.11.80.

Practical conduct of open heart procedures for congenital heart lesions

T K Susheel Kumar  1
Affiliations
Review

Practical conduct of open heart procedures for congenital heart lesions

T K Susheel Kumar. J Thorac Dis. 2020 Mar.

Abstract

Open heart surgery on infants with congenital heart lesions can be challenging not only in terms of the surgical procedure itself but also for setting up ideal conditions for safe and smooth conduct of cardiopulmonary bypass (CPB). The surgeon has to deal with a variety of lesions in a subgroup of patients who offer little room for any error. Familiarity with the principles of CPB, check lists and protocols go a long way in improving outcome in this critical group of patients.

Keywords: Cardiopulmonary bypass (CPB); children; congenital.

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Conflict of interest statement

Conflicts of Interest: The series “Management of Congenital Heart Disease” was commissioned by the editorial office without any funding or sponsorship. The author has no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
The typical sequence of an open heart operation.
Figure 2
Figure 2
The possible manipulation of flows on CPB and its effects. CPB, cardiopulmonary bypass.
Figure 3
Figure 3
Optimal drainage of IVC cannula. IVC cannula drains entire IVC return and some of the CS return. A beating RV handles the rest of the CS return but distends during cardiac arrest. IVC, inferior vena cava; CS, XX; RV, right ventricle.
Figure 4
Figure 4
Poor drainage of IVC cannula. IVC cannula barely drains entire venous return. Snugging of IVC often improves return. IVC, inferior vena cava.
Figure 5
Figure 5
Comparison of strategies for aortic cross clamp following circulatory arrest. CPB, cardiopulmonary bypass.
See this image and copyright information in PMC

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