Intracardiac Surgery with Extracorporeal Circulation in Infants: Indications and Results

Experience with intracardiac surgery in infants indicates that for most anomalies the operative and late mortality after primary total correction is lower than the combined mortality after early palliation and delayed correction. In addition, there are secondary benefits of primary total correction in terms of reversal of retarded physical growth and social development and alleviation of parental anxiety. The relative merits of conventional cardiopulmonary bypass versus profound hypothermia, circulatory arrest, and limited cardiopulmonary bypass are as yet incompletely elucidated, particularly regarding the long-term effects of the second method on cerebral function. Indications for the use of each method will undoubtedly become clearer as reports of longer follow-up become available. At the University of Oregon Medical School, intracardiac operation using conventional cardiopulmonary bypass has been carried out in 108 infants under 2 years of age. Late hemodynamic studies and intellectual and social developmental testing indicate gratifying long-term results with this technique.