Abstract 17353: Cerebral Vasoreactivity is Limited in Single-ventricle Children With High Baseline Cerebral Blood Flow

• Published in: Circulation (New York, N.Y.) N.Y.), 2016-11, Vol.134 (Suppl_1 Suppl 1), p.A17353-A17353
• Main Authors: Schwab, Peter J, Busch, David R, Winters, Madeline E, Mensah-Brown, Kobina, Buckley, Erin M, Lynch, Jennifer M, Putt, Mary E, Ko, Tiffany S, Montenegro, Lisa M, Nicolson, Susan C, Spray, Thomas L, Gaynor, J W, Fuller, Stephanie, Vossough, Arastoo, Licht, Daniel J, Fogel, Mark A
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

BackgroundDepressed cerebral CO2 reactivity (CO2R) is a measure of stressed vascular reserve and is associated with hypoxic-ischemic neurological injury in pediatric patients.HypothesisDifferences exist in cerebral blood flow (CBF) and cerebrovascular reactivity between single ventricle (SV) patients at different stages of surgical palliation.MethodsImmediately prior to surgery for bidirectional Glenn (BDG) and Fontan, arterial spin labeling MRI (ASL-MRI) measurements of baseline and hypercapnic CBF were obtained in single ventricle patients. CO2R was quantified as percentage increase in CBF during hypercapnia per unit increase in arterial partial pressure of carbon dioxide (pCO2) from baseline. Baseline CBF and CO2R measurements were compared between pre-BDG and pre-Fontan groups. We also modeled the relationship between baseline CBF and CO2R.ResultsOf 109 subjects, 49 were evaluated immediately prior to BDG procedures and 60 immediately prior to Fontan procedures. Pre-BDG subjects had a median baseline CBF of 78.1 ml/100g/min, significantly lower than the Pre-Fontan median of 89.8 ml/100g/min (p