HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Marco Ricci Pierluca Lombardi Eliot Rosenkranz Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ricci, M. Articles by Rosenkranz, E. Search for Related Content PubMed PubMed Citation Articles by Ricci, M. Articles by Rosenkranz, E.

Ann Thorac Surg 2005;80:686-694
© 2005 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

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

^a Division of Cardiothoracic Surgery, University of Miami Miller School of Medicine, Miami, Florida
^b Division of Pediatric Cardiology, University of Miami Miller School of Medicine, Miami, Florida
^c Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida

Accepted for publication March 4, 2005.

^_* Address reprint requests to Dr Ricci, Division of Cardiothoracic Surgery, Daughtry Family Department of Surgery, University of Miami, Holtz Center 3072 (R-114), 1611 NW 12th Ave, Miami, FL33136 (Email: mricci{at}med.miami.edu).

Presented at the Forty-first Annual Meeting of The Society of Thoracic Surgeons, Tampa, FL, Jan 24–26, 2005.

BACKGROUND: In single-ventricle physiology, cerebral blood flow and oxygen (O₂) delivery may be inadequate. This study tests the hypotheses that in acute univentricular physiology (1) cerebral blood flow increases inadequately to maintain O₂ delivery, (2) the brain is incapable of increasing O₂ extraction due to hypoxemia, and (3) cerebral O₂ delivery diminishes selectively in different brain regions.

MATERIAL AND METHODS: Univentricular physiology was created in 8 piglets, while 8 animals were sham controls. Aortopulmonary shunt, echocardiography-guided atrial septostomy, tricuspid valve avulsion, and pulmonary artery occlusion were performed to allow the left ventricle to support systemic and pulmonary circulations. Cerebral blood flow (microspheres), cerebral O₂ and lactate metabolism, and cerebral O₂ saturation were measured at baseline, 30 minutes, and 120 minutes after conversion to univentricular physiology.

RESULTS: Cerebral blood flow increased in the cerebrum and subtentorium in controls (p < 0.05), whereas it remained unchanged in univentricular piglets. Cerebral O₂ delivery at 30 and 120 minutes was lower in univentricular physiology than in controls (p = 0.05). Fractional oxygen extraction was unchanged in both groups. Cerebral O₂ consumption trended lower in univentricular physiology (p = not significant), while it was unchanged in controls. Lactate cerebral metabolic rate (CMR_Lactate) increased at 30 and 120 minutes in both groups. The decline in O₂ delivery was variable, but present in nearly all brain regions.

CONCLUSIONS: This study confirms the hypothesis that, in univentricular physiology, hypoxemia and limited cerebral blood flow reduce cerebral O₂ availability in nearly all regions. These findings contribute to the understanding of brain abnormalities in infants with univentricular physiology.

This article has been cited by other articles:

				M. Ricci, P. Lombardi, A. Galindo, S. Schultz, A. Vasquez, and E. Rosenkranz Effects of single-ventricle physiology with aortopulmonary shunt on regional myocardial blood flow in a piglet model. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 252 - 259.e2. [Abstract] [Full Text] [PDF]