| Autor: |
Tatyana A. Bergen, Ilya A. Soynov, Nina D. Anfinogenova, Wladimir Yu. Ussov, Alexey Ilin, Natalya T. Pak, Eugenii Kobelev, Yury N. Gorbatykh, Aleksandr M. Chernyavskiy |
| Rok vydání: |
2022 |
| DOI: |
10.21203/rs.3.rs-1495644/v1 |
| Popis: |
Background: Occurrence of cerebrovascular events in neonates after reconstruction of the aortic arch remains a common. The purpose of the study was to analyze immediate neurologic outcomes in neonates with aortic coarctation/hypoplastic aortic arch based on modified brain MRI after a reconstructive surgery. Methods: A total of 40 neonates with aortic coarctation/hypoplastic aortic arch underwent reconstructive aortic arch reconstruction. All patients were divided to two groups: group 1 comprised patients who underwent aortic arch repair (AAR) with deep hypothermic circulatory arrest (DHCA); group 2 comprised patients with antegrade cerebral perfusion by double arterial cannulation (ACP). All individuals underwent brain examination with MRI (DWI, SWI, T1, double echo) five to seven days after surgery.Results: According analysis MRI examination must include diffusion-, T2*-, T1 and dual-echo weighted imaging during perioperative period of AAR. The frequency of cerebrovascular events (CVE) was significantly higher in group 1 compared with group 2 (70 vs. 30%; p = 0.025). Air embolic occlusion and infarction of watershed zones were observed in the group with deep hypothermic circulatory arrest (35.7% vs. 0%; p = 0.25). The incidence rates of cortical laminar necrosis and intracranial hematoma was similar between groups. Conclusion: Double arterial cannulation was a more protective technique in terms of preventing CVE. Targeted MRI administration for the brain examination of neonates in the early postoperative period allowed to identify intracranial CVE that occurred in the early postoperative period and detect the pathology of the brain structures that were not associated with surgical treatment. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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