Abstract
Transcranial Doppler (TCD) was used to evaluate brain circulation during cardiac catheterizations in 32 children requiring pulmonary (n=10) or aortic balloon dilatations (n=2), ductus arteriosus coil insertions (n=5), or angiography (n=15). Cerebral blood flow velocity (CBFV) in the middle cerebral artery was measured before (baseline), during, and after each procedure (mean+/-95%ci). High-intensity transient signals (HITS) were also detected during these maneuvers. Balloon angioplasty decreased CBFV by 63+/-11% from baseline (P < 0.01). Shorter durations of the inflation cycle resulted in earlier CBFV recovery (r=0.78). During angiography, CBFV increased by 11+/-4% (P < 0.01) in all except one case that showed retrograde diastolic flow. Mean total HITS count was 44 (95%ci.limits: 27,74). These signals were more frequently found in septal defects or systemic arterial manipulations. Pediatric cardiac catheterization may impose transient fluctuations in brain perfusion as indicated by TCD, but their clinical implications are uncertain. CBFV changes during balloon angioplasty emphasize the importance of rapid inflation/deflation cycles. TCD can monitor such changes and evaluate preventive measures.
References
Aug 1, 1976·British Journal of Anaesthesia·N A Lassen, M S Christensen
Oct 1, 1978·The Journal of Clinical Investigation·D D HeistadF M Abboud
Jan 1, 1979·The Journal of Pediatrics·H C LouB Friis-Hansen
Feb 1, 1991·Stroke; a Journal of Cerebral Circulation·D RussellJ A Zivin
Dec 1, 1990·Early Human Development·V T RamaekersG Marchal
Feb 1, 1990·Angiology·R KarnikJ Slany
Jan 1, 1989·Stroke; a Journal of Cerebral Circulation·R AaslidH Nornes
Jan 1, 1989·Journal of Child Neurology·H Bode, A Eden
Sep 1, 1987·The Annals of Thoracic Surgery·T S PadayacheeP B Deverall
Nov 16, 1985·British Medical Journal·P J ShawD A Shaw
Sep 1, 1988·Acta paediatrica Scandinavica·S A CalvertA T Shennan
Apr 26, 1980·Lancet·S M Gelbart, S J Sontag
Apr 26, 1980·Lancet·D W Milligan
May 1, 1980·Circulation Research·D W BusijaM L Marcus
Nov 1, 1995·Stroke; a Journal of Cerebral Circulation·H SugimoriM Fujishima
May 1, 1995·The Annals of Thoracic Surgery·C I Blauth
May 1, 1995·Stroke; a Journal of Cerebral Circulation·A A BirchG Neil-Dwyer
Aug 1, 1994·Stroke; a Journal of Cerebral Circulation·V L BabikianM R Winter
Oct 1, 1994·Stroke; a Journal of Cerebral Circulation·F S LarsenG M Knudsen
Jul 1, 1994·Stroke; a Journal of Cerebral Circulation·W PugsleyS Newman
Sep 1, 1993·Archives of Disease in Childhood·M Y AnthonyM I Levene
Aug 1, 1993·Stroke; a Journal of Cerebral Circulation·H Markus
Dec 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·R A RodriguezS M Audenaert
Jan 1, 1996·Archives of Disease in Childhood. Fetal and Neonatal Edition·O Pryds, A D Edwards
Citations
Apr 17, 2004·Paediatric Anaesthesia·G A Orliaguet
Feb 14, 2014·Cardiology in the Young·Sean WallaceDavid Russell
Feb 1, 2017·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Kerri L LaRovereBarry D Kussman
Jan 8, 2011·Journal of Child Neurology·Michael M Dowling, Catherine M Ikemba
Mar 26, 2021·Anesthesia and Analgesia·Barry D KussmanKerri LaRovere