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(Circulation. 1967;35:I-105.)
© 1967 American Heart Association, Inc.

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Correction of Total Anomalous Pulmonary Venous Drainage in Infancy Utilizing Deep Hypothermia with Total Circulatory Arrest

DAVID H. DILLARD M.D.¹; HITOSHI MOHRI M.D., D.MED.SC.¹; EUGENE A. HESSEL II M.D.¹; HOWARD N. ANDERSON M.D.¹; RONALD J. NELSON M.D.¹; EDWARD W. CRAWFORD M.D.¹; BEVERLY C. MORGAN M.D.¹; LOREN C. WINTERSCHEID M.D., PH.D.¹; K. ALVIN MERENDINO M.D., PH.D.¹

¹ From the Departments of Surgery, Anesthesiology, and Pediatrics, University of Washington School of Medicine; and the First University Surgical Service, University Hospital, Seattle, Washington.

Four critically ill infants aged 3, 5, 5, and 13 months; weighing 3.7, 4.6, 5.3, and 6.5 kg, respectively; with total anomalous pulmonary venous drainage, underwent complete correction of their lesions with the utilization of surface-induced deep hypothermia. Although this series is small, we are not aware of any other consecutive series in this age group with a comparable mortality rate. Rectal temperatures of 17.5 to 20.2 C were utilized, with periods of cardiac arrest and total circulatory interruption of 32 to 41 minutes. Important aspects of the technique are surface cooling, deep ether anesthesia, intravenous low-molecular-weight dextran, induced respiratory alkalosis during cooling, and electrical pacing during resuscitation. This method works well in the infant, in contrast with perfusion techniques in which surgical mortality is excessively high.