Preliminary results show that the Venus P-valve can be safely and efficaciously used in dilated right ventricular outflow tracts of varying morphology. Rigorous trials will be required to evaluate this valve before more widespread use.

Background: Regional changes in cerebral blood flow and perfusion are implicated in the pathogenesis of adverse neurological events that lead to death and severe disability in the newborn infant. The basal ganglia, in particular, are extremely sensitive to acute hypoxia in the perinatal period, but normal perfusion to this area is unknown. Objectives: To establish a reference range for regional basal ganglia perfusion using fractional moving blood volume (FMBV) as an index. Methods: Head ultrasounds were performed on neonates from 25 to 41 weeks' gestation. Power Doppler images were obtained from a pre-specified coronal plane. FMBV was calculated offline after selecting the basal ganglia as a region of interest. The average of five calculations was considered to be representative of the regional perfusion for each neonate. The data were analysed, and a neonatal reference range was defined. Results: 124 neonates were included in the study, and all had analysable data. The mean FMBV was 28.8% (±9.6) with a reference range defined as 10-48%. The mean FMBV for neonates <32 weeks', 32-35 weeks' and >35 weeks' gestation were 29.4% (±7.8), 29.2% (±11.0) and 27.4% (±9.7), respectively. Analysis of variance showed no significant difference between neonates based on gestation. Conclusions: We have successfully used the index FMBV to define a reference range for perfusion in the basal ganglia. These data can be used as a reference for subsequent studies that evaluate basal ganglia perfusion in pathological conditions.

Background:The preterm brain is susceptible to changes in blood flow. Using power Doppler images, digital imaging techniques have been developed to measure the total amount of blood flow in a defined area, giving the index: fractional moving blood volume (FMBV). The aim of this study was to investigate temporal changes in basal ganglia perfusion during the transitional period after birth. Methods: Twenty-four preterm infants were examined with serial cranial ultrasounds at four time points during the first 48 h of life. FMBV was calculated using power Doppler images at each time point. results: All infants had analyzable data and FMBV was successfully calculated at all time points. Twenty-three of the 24 infants had an increasing trend in FMBV over time. The median FMBV increased from 17% at 6 h to 25% at 48 h. Oneway repeated measures ANOVA showed a significant increase in values at P < 0.001 at each of the four time points. conclusion: We have demonstrated changes in basal ganglia blood flow as the cerebral circulation adapts to extrauterine life. With further investigation, this technique may be useful in the assessment of preterm circulatory adaptation, either alone or in conjunction with other modes of evaluating cerebral blood flow.

This study shows that STIC data sets can be used to calculate volumetric impedance indices in the neonatal brain. Preliminary assessment shows that this technique appears reliable and allows evaluation of regional tissue impedance in the neonate.