Efficacy of cardiopulmonary bypass method with blood delivery via femoral artery cannulation for paediatric aortic arch repair

Abstract Introduction The efficacy of cardiopulmonary bypass (CPB) management with blood delivery via femoral artery cannulation for paediatric aortic arch repair has yet to be reported. This study aimed to verify the hypothesis that this CPB method would reduce lactate elevation compared to CPB management using circulatory arrest of the lower body under deep hypothermia. Methods This study included patients who underwent paediatric aortic arch repairs between March 2012 and March 2018 at the German Paediatric Heart Centre, Sankt Augustin. Patients who were repumped intraoperatively were excluded. Group A (lower body circulatory arrest), Group F (retrograde aortic perfusion via femoral artery cannulation), and Group D (antegrade descending aortic perfusion) included 41, 18, and 15 patients, respectively. The CPB records were retrospectively reviewed for the minimum body temperature during CPB (℃), lactate levels before CPB (mmol/L), CPB duration (min), aortic clamp time duration (min), total urine output (mL) and changes in lactate levels during CPB (mmol/L). Results The minimum body temperatures during CPB were 16.79 ± 1.48℃, 23.73 ± 4.67℃, and 30.59 ± 2.35 ℃ in Groups A, F, and D, respectively. The increases in lactate levels during CPB in Group F (1.06 ± 0.94) were significantly lower than in Group A (1.66 ± 0.90, p = 0.033); however, no different from Group D (0.92 ± 1.13, p = 0.807). Conclusion This CPB method is a promising alternative to the CPB method using antegrade descending aortic perfusion for paediatric aortic arch repair. Trial registration UMIN000052933.