CEREBRAL BLOOD-FLOW VELOCITIES MONITORED BY TRANSCRANIAL DOPPLER DURING CARDIAC CATHETERIZATIONS IN CHILDREN

Transcranial Doppler (TCD) was used to evaluate brain circulation duri ng cardiac catheterizations in 32 children requiring pulmonary (n=10) or aortic balloon dilatations (n=2), ductus arteriosus coil insertions (n=5), or angiography (n=15). Cerebral blood flow Velocity (CBFV) in the middle cerebral artery was measured before (baseline), during, and after each procedure (mean +/- 95%ci). High-intensity transient signa ls (HITS) were also detected during these maneuvers. Balloon angioplas ty decreased CBFV by 63 +/- 11 % from baseline (P < 0.01). Shorter dur ations of the inflation cycle resulted in earlier CBFV recovery (r=0.7 8). During angiography, CBFV increased by 11 +/- 4% (P < 0.01) in all except one case that showed retrograde diastolic flow. Mean total HITS count was 44 (95%ci.limits: 27,74), These signals were more frequentl y found in septal defects or systemic arterial manipulations, Pediatri c cardiac catheterization may impose transient fluctuations in brain p erfusion as indicated by TCD, bur their clinical implications are unce rtain, CBFV changes during balloon angioplasty emphasize the importanc e of rapid inflation/deflation cycles, TCD can monitor such changes an d evaluate preventive measures. (C) 1998 Wiley-Liss, Inc.