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Reduction of Carotid Arterial Blood Flow in Ventricular Septal Defect Associated With Severe Congestive Heart Failure
Author(s) -
Kojo Masanobu,
Yamada Katsuhiko,
Akiyoshi Shinnosuke,
Maeda Miwako,
Sato Keisuke,
Izumi Tatsuro
Publication year - 2000
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon2000104241
Subject(s) - medicine , cardiology , heart failure , body surface area , cerebral blood flow , shunt (medical) , stroke volume , ejection fraction
After diagnosing abnormality of cardiac and carotid‐cerebral circulation in an infant with isolated ventricular septal defect (VSD) associated with severe congestive heart failure, the authors measured the carotid arterial blood flow volume (CABF). At 3 months, the patient was not thriving and had dyspnea because of severe congestive heart failure. The authors measured the VSD size/body surface area (BSA) ratio relative to the predicted value of the left ventricular end‐diastolic dimension (%LVEDd), left‐to‐right shunt ratio (Qp/Qs), and the small stroke volume (SV)/BSA using echocardiography and cardiac catheterization. The mean, maximum, and minimum CABF (mean CABF, maxCABF, and minCABF) among R‐R intervals on electrocardiogram were measured by Doppler flowmetry in this patient and 5 healthy age‐matched control children. The patient had a large VSD size/BSA ratio (37.9 mm/m 2 ), %LVEDd (164%), and Qp/Qs (3.8), and a small SV/BSA ratio (18 mUm2 ). The mean CABF, maxCABF, and minCABF were significantly lower than those of control children (VSD patient vs. controls; 2.7 ± 0.4vs. 4.5 ± 0.6, 6.1 ± 0.9 vs. 12.0 ± 2.1, 1.2 ± 0.2 vs. 1.7 ± 0.4 mL sec (mean ± S.D.)), respectively ( p < 0.01 ). The authors' results showed abnormal cardiac and carotid‐cerebral circulation in an infant with large VSD associated with severe congestive heart failure.