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Abstract #0845

Preclinical 1H MRS Study of a Porcine Model Shows Evidence and Mechanisms for Neuronal Injury in Neonatal Cardiopulmonary Bypass Surgery

Aaron Omon1, Daniel Spielman1, Meng Gu1, Ralph Hurd1, Kirk Riemer2, and Frank Hanley2
1Radiology, Stanford University School of Medicine, Stanford, CA, United States, 2Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States

Synopsis

Keywords: Neonatal, biomarkers, Metabolism, Brain, Diagnosis/prediction, Neonatal, Preclinical, Spectroscopy, Surgery

Motivation: To investigate metabolic processes contributing to neuronal damage during neonatal cardiopulmonary bypass (CPB) surgery.

Goal(s): Use 1H MRS to measure changes in glucose, phosphocreatine, succinate, and ammonia during different phases of CPB surgery and assess their correlations with N-acetyl-aspartate (NAA), a marker of acute brain injury.

Approach: Studies were conducted on a porcine model at varying bypass temperatures, using either antegrade cerebral perfusion or complete circulatory arrest (CA), to examine effects on neuronal injury.

Results: 1H MRS detected brain damage that correlated with surgical parameters and key metabolites, with greater NAA losses observed during CA and at higher temperatures.

Impact: Understanding how different surgical approaches affect patient outcomes will enable clinics to implement safer protocols for neonates with congenital heart disease, who face a greater risk of neurodevelopmental delays from these critical procedures.

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