Cerebral blood flow following hypothermic circulatory arrest

Hypothermic circulatory arrest has been an important adjunct in pediatric cardiovascular surgery. Historically, use of hypothermia allowed the first intracardiac repair prior to the successful application of cardiopulmonary bypass and well before the advent of cardioplegic cardiac arrest. Today, the repair of many complex defectsis greatly facilitated by the use of hypothermic arrest. Despite the importance of the technique in the armamentarium of the congenital heart surgeon, the physiology of cerebral injury associated with hypothermic arrest has not been fully elucidated. To understand this physiology better, a number of investigators have focused on cerebral reperfusion after the event. In this review, we discuss findings from our own studies in the light of other available data on global and regional flow of blood to the brain following hypothermic arrest.