Changes in Cerebral Hemodynamics During Systemic Pulmonary Shunt and Pulmonary Artery Banding in Infants with Congenital Heart Disease

Takeda, Yoshifumi; Yamamoto, Masataka; Hoshino, Koji; Ito, Yoichi M.; Kato, Nobuyasu; Wakasa, Satoru; Morimoto, Yuji

Changes in Cerebral Hemodynamics During Systemic Pulmonary Shunt and Pulmonary Artery Banding in Infants with Congenital Heart Disease

Takeda, Yoshifumi; Yamamoto, Masataka; Hoshino, Koji et al.

Pediatric cardiology, 2023, 44(3), 695-701

Permalink : https://hdl.handle.net/2115/91337

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アクセス権	open access
URI	https://hdl.handle.net/2115/91337
タイトル	Changes in Cerebral Hemodynamics During Systemic Pulmonary Shunt and Pulmonary Artery Banding in Infants with Congenital Heart Disease
著者	Takeda, Yoshifumi ; Yamamoto, Masataka ; Hoshino, Koji ; Ito, Yoichi M. ; Kato, Nobuyasu ; Wakasa, Satoru ; Morimoto, Yuji
著者名 Takeda, Yoshifumi
著者名 Yamamoto, Masataka
著者名 Hoshino, Koji
e-Rad_Researcher 10334236 著者名 Ito, Yoichi M.
著者名 Kato, Nobuyasu
e-Rad_Researcher 10374365 著者名 Wakasa, Satoru
e-Rad_Researcher 00250457 著者名 Morimoto, Yuji
言語	英語
キーワード	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
発行日	2023-03-01
出版者	Springer
収録物名	Pediatric cardiology
巻(号)	44(3)
ページ	695-701
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	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
PISSN	0172-0643
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00246-022-02999-6