Preservation of Brain Oxygen Metabolism in Emerging Young Adult Survivors of Fontan Palliation for Single Ventricle.
Jian Shen1, Silvie Suriany2, Clio Gonzalez-Zaccarias3, Botian Xu1, Ashok Panigraphy4, Jon Detterich2, and John C Wood5
1Bioengineering, University of Southern California, Los Angeles, CA, United States, 2Children's Hospital of Los Angeles-USC KSOM, Los Angeles, CA, United States, 3Neurosciences, University of Southern California, Los Angeles, CA, United States, 4Radiology, Children's Hospital Pittsburgh, Pittsburgh, PA, United States, 5Pediatrics, Children's Hospital of Los Angeles-USC KSOM, Los Angeles, CA, United States
Surgical palliation of single ventricular heart disease (Fontan procedure) leads to poor cardiac output, high central venous pressures, and long-term multiorgan morbidity. We report cerebral blood flow, brain oxygen delivery, and cerebral metabolic rate in 20 Fontan survivors and 9 control subjects. Fontan patients had lower cerebral blood flow and oxygen saturation but maintained cerebral oxygen delivery and cerebral metabolic rate of oxygen (CMRO2) because of polycythemia. Scattergram between CMRO2 and O2 delivery suggests similar oxygen extraction at the microvascular level in both groups. Taken together, these data suggest adequate cerebrovascular compensation to low cardiac output in Fontan patients.
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