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Review
. 2021 Jan;37(Suppl 1):165-173.
doi: 10.1007/s12055-020-00930-3. Epub 2020 Mar 9.

Total circulatory arrest as a support modality in congenital heart surgery: review and current evidence

Debasis Das  1 , Nilanjan Dutta  1 , Kuntal Roy Chowdhuri  2
Affiliations
Review

Total circulatory arrest as a support modality in congenital heart surgery: review and current evidence

Debasis Das et al. Indian J Thorac Cardiovasc Surg. 2021 Jan.

Abstract

The use of total circulatory arrest (TCA)/deep hypothermic circulatory arrest (DHCA) as a support modality in congenital heart surgery is a time-tested strategy. However, with technological advances, the widespread use of this technique has decreased. Adjunctive cerebral perfusion with continuous cardiopulmonary bypass (CPB) gradually has become more popular with a view to reduce the complications related to DHCA. In addition, better neuromonitoring and neuroprotective strategies have made DHCA much safer. However, the level of evidence to support the best way to protect the brain during congenital heart surgery is insufficient. This review analyzes the history, physiology, techniques of DHCA, as well as other alternative strategies like selective cerebral perfusion and presents the current available evidence.

Keywords: Cerebral perfusion; Deep hypothermic circulatory arrest (DHCA); Neuroprotection.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

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