The Effects Of Corrective Surgical Treatment On Cerebral Hemodynamics İn Pediatric Patients With Congenital Heart Disease
Özet
Background: Cerebral blood flow (CBF) is meticulously regulated by various powerful mechanisms. Both acute and chronic changes in cardiac output have been shown to cause changes in CBF.
Objectives: The aim of this study was to investigate the chronic effects of total corrective surgical treatment on cerebral hemodynamics in children with cyanotic and non-cyanotic congenital heart disease (CHD).
Methods: A total of 34 patients with cyanotic (n = 12) and non-cyanotic (n = 22) CHD aged between 6 months and 6 years were included in the study. The middle cerebral artery (MCA) flow rates were measured with transcranial Doppler (TCD) twice, preoperatively and between 3 and 6 months after surgery.
Results: When the preoperative and postoperative MCA values of non-cyanotic patients were compared, it was observed that postoperative MCA values, decreased end-diastolic flow velocity and resistance index (RI) values increased. When the preoperative and flows of cyanotic patients were compared, postoperative MCA values were found increased in the RI, pulsatility index and systolic/diastolic ratio values. These changes were statistically significant in the positive direction.
Conclusions: Our results show that CBF returns to normal in non-cyanotic patients due to the improvement of cerebral autoregulation after corrective surgical treatment, and there is partial improvement in cyanotic patients.