Patient population
With the approval of the institution’s ethics committee, 173 pediatric cardiac patients who underwent aortic arch reconstruction with cardiopulmonary bypass through median sternotomy between January 2011 and February 2020 were reviewed. We switched from the ACP and CA perfusion strategy, which was used for the initial 60 patients (35%) to the ACP and coronary perfusion strategy after November 2014. The ACP and coronary perfusion strategy was then used in a consecutive series of 113 patients (65%). The patients were divided into two groups according to perfusion strategy: BHAS group underwent the BHAS procedure and CA group underwent the ACP-CA. Cardiac patients diagnosed with hypoplastic left heart syndrome, interrupted aortic arch, and coarctation repair through thoracotomy were excluded from the study. Patients who underwent isolated arch reconstruction, ventricular septal defect (VSD) repair with arch reconstruction, or complex cardiac procedures other than VSD repair with arch reconstruction were included in the study. 49 of these patients had a PDA dependent circulation. Patients with single-ventricle physiology were also included in the study.