Key result
Sustained total all-region (STAR) perfusion allows the Norwood procedure to be completed with mild hypothermia and continuous perfusion to all vascular beds.
STAR perfusion is an optimized strategy for Norwood reconstruction that provides continuous perfusion to all vascular beds and reduces cardiopulmonary bypass and total operative times.
Describes novel STAR perfusion for Norwood; hypothesis-generating and requires prospective validation before clinical adoption.
pediatric arterial cannula, with a high-flow stopcock attached, is placed in the ascending aorta or innominate artery to provide flow to the head. A cardioplegia needle with walrus tubing is connected to the stopcock to provide flow to the coronary arteries. For lower body perfusion, an olive tip cannula is placed into the descending aorta lumen and attached to the 1/8″ line from the cardioplegia system which provides warm arterial blood flow. STAR perfusion allows the Norwood procedure to be completed with mild hypothermia and continuous perfusion to all vascular beds with reduced cardiopulmonary bypass as well as total operative times. This technique is successfully achieved with minimal changes to circuitry, minor modifications to heart-lung machine servoregulation and few additional cannulation disposables.
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Siffring et al. (2020) studied Hypoplastic left heart syndrome. Sustained Total All-Region (STAR) perfusion was evaluated. Sustained total all-region (STAR) perfusion allows the Norwood procedure to be completed with mild hypothermia and continuous perfusion to all vascular beds.
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