Single-Ventricle Physiology Reduces Cerebral Oxygen Delivery in a Piglet Model

Current insights regarding neurological and developmental abnormalities in children and young adults with complex congenital cardiac disease

“…The cerebral vascular response to increased inspired carbon dioxide was preserved, suggesting normal autoregulation of cerebral blood flow, at least over the short term. The finding of reduced cerebral blood flow and abnormal vascular reactivity has recently been confirmed in a neonatal piglet model of functionally univentricular physiology by Ricci et al 47…”

Advances in cardiac intensive care

“…Physiologically, CHD may alter cerebral blood flow, oxygen delivery, or both, and result in secondary effects on the vulnerable fetal central nervous system (CNS) [95 ,96]. Ultrasound studies have revealed that cerebral vascular resistance is altered in the presence of congenital cardiac disease [96,97], and Licht et al [98] demonstrated, in addition to the diminished content of oxygen, that neonates with critical congenital cardiac disease also suffered from diminished cerebral blood flow. These factors may be largely non-modifiable.…”

Effects of single-ventricle physiology with aortopulmonary shunt on regional myocardial blood flow in a piglet model

“…Rectal temperature was kept at 35.5°C to 36.5°C. On the basis of previous experience, 13,14 normal saline (4 mL • kg Ϫ1 • h Ϫ1 ), dopamine (5-10 g • kg Ϫ1 • min Ϫ1 ), and epinephrine (0.05-0.1 g • kg Ϫ1 • h Ϫ1 ) were administered to maintain cardiovascular stability in the SVP group. Inotropic support was managed identically in sham-operated controls to allow meaningful comparisons.…”

“…Stable-isotope microspheres (15 Ϯ 5 m) (BioPhysics Assay Laboratory, Inc., Worcester, Mass) were used as described previously. [13][14][15] Microspheres labeled with gold, samarium, ytterbium, and lutetium were administered over 3 to 5 seconds in the left atrium, while reference samples were collected over 90 seconds from the femoral artery (2 mL/min). A total of 1 ϫ 10 6 microspheres were injected in the biventricular state, whereas 2.5 ϫ 10 6 microspheres were injected in SVP.…”

“…15 Regional MBF was expressed in milliliters per minute per 100 gm, and calculated by normalizing the concentration of microspheres in the tissue sample to the concentration in the reference sample. [13][14][15] Physiologic measurements and calculations. Total cardiac output (excluding coronary blood flow) was determined by an electromagnetic perivascular flowmeter (Transonic Systems Inc, Ithaca, NY) placed on the ascending aorta.…”