{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:08:09Z","timestamp":1775567289490,"version":"3.50.1"},"reference-count":18,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Neonatal and infant aortic arch reconstruction remains a high-risk cardiovascular procedure requiring effective cerebral and myocardial protection. Variability in perfusion strategies may influence early hemodynamic stability and postoperative recovery. This study aimed to evaluate the early and short-term cardiovascular outcomes of a standardized beating-heart aortic arch reconstruction strategy incorporating simultaneous antegrade selective cerebral and continuous coronary perfusion. Methods: In this retrospective single-center cohort study, 31 consecutive neonates and infants undergoing aortic arch reconstruction between November 2022 and December 2025 were analyzed. A standardized surgical protocol was applied, consisting of extensive ductal tissue resection, interdigitating posterior end-to-end anastomosis, anterior autologous pericardial patch augmentation, and moderate hypothermic antegrade selective cerebral perfusion combined with continuous coronary perfusion via innominate artery cannulation. Early postoperative outcomes and short-term echocardiographic follow-up results were assessed. Results: The cohort included 31 patients, 22.6% of whom had complex associated cardiac anomalies requiring concomitant procedures. Median cardiopulmonary bypass and aortic cross-clamp times were 119 and 64 min, respectively. There was no in-hospital mortality. Major complications were infrequent, and median intensive care unit stay was 5 days. During a median follow-up of 6.8 months, one patient (3.2%) developed recoarctation requiring reintervention. No late mortality was observed. Conclusions: A fully standardized beating-heart aortic arch reconstruction strategy incorporating simultaneous cerebral and coronary perfusion demonstrated favorable early cardiovascular and short-term outcomes, even in anatomically complex cases. Preservation of continuous coronary perfusion may be associated with improved myocardial stability and early postoperative recovery; however, these findings should be interpreted as observational and hypothesis-generating given the absence of a control group. Larger multicenter studies with longer follow-up are warranted to confirm these findings.<\/jats:p>","DOI":"10.3390\/jcdd13040161","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T12:03:47Z","timestamp":1775563427000},"page":"161","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Standardized Beating-Heart Aortic Arch Reconstruction with Simultaneous Cerebral and Coronary Perfusion in Neonates and Infants: A Single-Center Cardiovascular Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2022-9430","authenticated-orcid":false,"given":"Shiraslan","family":"Bakhshaliyev","sequence":"first","affiliation":[{"name":"Pediatric Cardiovascular Surgery Department, Atlas University Hospital, Istanbul 34203, Turkey"},{"name":"Pediatric Cardiovascular Surgery Department, Liv Bona Dea Hospital, Baku 1060, Azerbaijan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-7062","authenticated-orcid":false,"given":"Ergin","family":"Arslanoglu","sequence":"additional","affiliation":[{"name":"Pediatric Cardiovascular Surgery Department, Atlas University Hospital, Istanbul 34203, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1016\/j.jtcvs.2006.11.029","article-title":"A randomized clinical trial of regional cerebral perfusion versus deep hypothermic circulatory arrest: Outcomes for infants with functional single ventricle","volume":"133","author":"Goldberg","year":"2007","journal-title":"J. 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Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.athoracsur.2012.10.029","article-title":"Direct innominate artery cannulation for antegrade cerebral perfusion in neonates undergoing arch reconstruction","volume":"95","author":"Amir","year":"2013","journal-title":"Ann. Thorac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1177\/02676591241276980","article-title":"Evaluation of end-organ protection in newborns and infants after surgery of aortic arch hypoplasia: A prospective randomized study","volume":"40","author":"Soynov","year":"2025","journal-title":"Perfusion"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/4\/161\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T12:35:03Z","timestamp":1775565303000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/4\/161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["jcdd13040161"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13040161","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]}}}