Congenital heart disease refers to a group of heart conditions that develop before birth. It occurs when the heart or blood vessels around the heart don't form properly during fetal development. The severity of congenital heart disease can range from mild, where it may not even require treatment, to severe, where it can lead to life-threatening complications.
The causes of congenital heart disease are often unknown, but genetics, infections, and environmental factors can all play a role. Advances in medical technology and surgical techniques have improved the survival rate and quality of life for individuals with congenital heart disease. However, it remains a significant health concern, affecting approximately 1% of all live births globally.
While advances in technology have led to improvements in surgical techniques, it is still important to investigate the effects of perfusion modalities on cerebral hemodynamics, vital organ injury, and clinical outcomes. This randomized clinical trial aimed to investigate these effects in risk-stratified congenital cardiac surgery patients.
The trial included 159 consecutive congenital cardiac surgery patients, half of whom received pulsatile perfusion and half of whom received non-pulsatile perfusion. Cerebral hemodynamics were assessed using transcranial Doppler ultrasound, and multiple organ injury was quantified using the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score at 24, 48, and 72 hours. Clinical outcomes, including intubation time, intensive care unit length of stay (LOS), hospital LOS, and mortality, were also evaluated.