Experience in management of cardiopulmonary bypass during intrapartum cardiac surgery
Miao Na
Zhang Xiaojuan
Zhao Xueting
Wang Jialu
Wang Xiaonan
Wang Qiang
Zhao Ju
Abstract：Objective To summarize the management of cardiopulmonary bypass(CPB)during delivery of critical congenital heart disease.Methods From December 2022 to April 2024,a total of 10 neonates with severe congenital heart disease underwent intrapartum surgery in the Pediatric Heart Center of our hospital.The clinical data,CPB management data,cardiac laboratory examinations before and after surgery,and postoperative clinical results were retrospectively analyzed.Results CPB time of all neonates was(167.40±75.18)min and aortic occlusion time was(107.80±57.18)min.All neonates were stopped without delayed chest closure.The average dosage of heparin during CPB was(5.50±1.37)mg/kg.Blood bank pre-charge was(0.8-1)U;Improved ultrafiltration time was(9.1±1.29)min;Total filtrate volume was(469±96.15)ml;Protamine dosage was(9.54±1.48)mg/kg.One patient underwent a second tricuspid valvuloplasty 45 days after surgery due to moderate and severe tricuspid regurgitation.One patient died of low cardiac output due to hypertrophy obstruction of ventricular septum.9 patients recovered successfully after operation and were discharged from hospital.Conclusion Intrapartum neonatal cardiac surgery can provide a new safe and earlier surgical treatment opportunity for children with complex and critical congenital heart disease under the close cooperation of multidisciplinary teams.CPB management involves the precise control of consumables selection,blood storage pre-filling,anticoagulation optimization,flow and blood pressure control,etc.It is very important to monitor oxygen supply and consumption during CPB.
Keywords：Cardiopulmonary bypassCriticalCongenital heart diseaseNewbornIntrapartum cardiac surgery
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 215-218 )