Patient population
With the approval of the institution’s ethics committee, 173 pediatric
cardiac patients who underwent aortic arch reconstruction with
cardiopulmonary bypass through median sternotomy between January 2011
and February 2020 were reviewed. We switched from the ACP and CA
perfusion strategy, which was used for the initial 60 patients (35%) to
the ACP and coronary perfusion strategy after November 2014. The ACP and
coronary perfusion strategy was then used in a consecutive series of 113
patients (65%). The patients were divided into two groups according to
perfusion strategy: BHAS group underwent the BHAS procedure and CA group
underwent the ACP-CA. Cardiac patients diagnosed with hypoplastic left
heart syndrome, interrupted aortic arch, and coarctation repair through
thoracotomy were excluded from the study. Patients who underwent
isolated arch reconstruction, ventricular septal defect (VSD) repair
with arch reconstruction, or complex cardiac procedures other than VSD
repair with arch reconstruction were included in the study. 49 of these
patients had a PDA dependent circulation. Patients with single-ventricle
physiology were also included in the study.