[Deep hypothermia and cardiocirculatory arrest with the technic of central cooling in patients with simple transposition of the great arteries].

The deep hypothermia and cardiocirculatory arrest are employed mainly for two reasons; to reduce as much as possible the extra corporeal circulation time in patients more suitable to present the deleterious effects of the by-pass circulation, and to have surgical field completely free from the blood, making easier some surgical procedures. In the classic description of Hykasa the deep hypothermia necessary to have a safe cardiocirculatory arrest is obtained by means of surface cooling and an extracorporeal heat exchanger. In our experience deep hypothermia and cardiocirculatory arrest were achieved only by means of core cooling technique; 64 patients with TGA weighing less than 10 kg were operated upon by this method with a mortality rate of 3.1%. The most important mortality risk factors were associated to the low weight of the patients and to the age. The major criticism against core cooling is represented by the thought that this type of cooling can impair cerebral function. In 2 patients we had neurological complications but were unrelated to the technique. We conclude that, when is necessary to perform a cardiocirculatory arrest, the core cooling deep hypothermia is a good, simple and useful technique, with a low danger of neurological complications.