The use of total circulatory arrest in the surgery of giant hemangioma and Klippel-Trenaunay syndrome in neonates.

Abstract

Two neonates required deep hypothermia and circulatory arrest to provide a central control of blood loss for the resection of giant cavernous hemangiomas. Both infants were placed on cardiopulmonary bypass, cooled to 16 degrees, and exsanguinated before resection of these peripheral lesions. The surgery was done as a lifesaving measure in both instances because both infants were suffering from high-output cardiac failure. In both cases, the small total blood volumes were critical in excision of these hypervascular tumors. Use of the techniques described allowed for the surgery to be performed in a bloodless field over a short period (one hour), thus preventing massive blood loss. Both patients are living with no neurologic or developmental deficits more than five years after the operation.