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Changes in Cerebral Hemodynamics During Systemic Pulmonary Shunt and Pulmonary Artery Banding in Infants with Congenital Heart Disease
| Title: | Changes in Cerebral Hemodynamics During Systemic Pulmonary Shunt and Pulmonary Artery Banding in Infants with Congenital Heart Disease |
| Authors: | Takeda, Yoshifumi Browse this author | | Yamamoto, Masataka Browse this author | | Hoshino, Koji Browse this author | | Ito, Yoichi M. Browse this author →KAKEN DB | | Kato, Nobuyasu Browse this author | | Wakasa, Satoru Browse this author →KAKEN DB | | Morimoto, Yuji Browse this author →KAKEN DB |
| Keywords: | Pediatric cardiac surgery | | Congenital heart disease | | Palliative surgery | | Systemic pulmonary shunt | | Blalock Taussig shunt | | Pulmonary artery banding | | Transcranial doppler | | Cerebral oxygen saturation | | Near infrared spectroscopy |
| Issue Date: | 1-Mar-2023 |
| Publisher: | Springer |
| Journal Title: | Pediatric cardiology |
| Volume: | 44 |
| Issue: | 3 |
| Start Page: | 695 |
| End Page: | 701 |
| Publisher DOI: | 10.1007/s00246-022-02999-6 |
| Abstract: | Palliative surgery is often performed in the treatment of congenital heart disease. Two representative palliative procedures are the systemic pulmonary shunt and pulmonary artery banding. Dramatic changes in cerebral hemodynamics may occur in these operations due to changes in the pulmonary-to-systemic blood flow ratio and systemic oxygenation. However, there seem to be almost no studies evaluating them. Accordingly, we evaluated cerebral perfusion by transcranial Doppler ultrasonography and cerebral oxygenation by near infrared spectroscopy during these procedures. In the post hoc analysis of a previous prospective observational study, cerebral blood flow velocities of the middle cerebral artery measured by transcranial Doppler were compared between the start and end of surgery as were the pulsatility index and resistance index. The cerebral oxygenation values were also compared between the start and end of surgery. Twenty-two infants with systemic pulmonary shunt and 20 infants with pulmonary artery banding were evaluated. There were no significant differences of the flow velocities between the start and end of surgery in either procedure. The pulsatility index significantly increased after pulmonary artery banding, which may compete with the increase in cerebral perfusion due to the increase in systemic blood flow. The cerebral oxygenation decreased in both procedures, possibly due to an increase in body temperature. Arterial oxygen saturation was almost the same before and after both procedures. Contrary to our expectation, the changes in cerebral hemodynamics in the palliative operations were small if the management of physiological indices such as arterial oxygen saturation was properly performed during the procedures. |
| Rights: | This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s00246-022-02999-6 |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/91337 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 森本 裕二
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