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This Article Full Text Full Text (PDF) All Versions of this Article: 293/2/H1138    most recent 00025.2007v1 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 Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Aburawi, E. H. Articles by Pesonen, E. Search for Related Content PubMed PubMed Citation Articles by Aburawi, E. H. Articles by Pesonen, E.

Effects of cardiopulmonary bypass surgery on coronary flow in children assessed with transthoracic Doppler echocardiography

¹Department of Pediatrics, Division of Pediatric Cardiology, Lund University Hospital, Lund, Sweden; and ²Institute of Clinical Medicine, Section of Pediatrics, University of Bergen, Bergen, Norway

Submitted 8 January 2007 ; accepted in final form 27 April 2007

Perturbation of coronary blood flow (CF) is an important contributor to myocardium-related complications. The study was primarily designed to assess the impact of cardiopulmonary bypass (CPB) surgery on CF by aid of transthoracic Doppler echocardiography. Changes in CF after off-pump coarctation surgery were also studied. All ultrasounds were performed before and 5 ± 1 days after surgery. Eighteen children underwent CPB surgery of ventricular left-to-right shunts at the mean age of 6 mo, while off-pump surgery (aortic coarctectomy) was undertaken at the mean age of 10 days in 12 children. After CPB surgery, both left anterior descending coronary artery mean diameter and basal CF increased from 1.7 ± 0.3 to 2.1 ± 0.4 mm (P = 0.001) and 27 ± 10 to 47 ± 15 ml/min (P = 0.0001), respectively. These two coronary variables decreased after off-pump coarctectomy: left anterior descending coronary artery mean diameter from 1.8 ± 0.1 to 1.7 ± 0.1 mm (P = 0.06), and CF from 44 ± 12 to 25 ± 8 ml/min (P = 0.001). The findings are in keeping with the hypothesis that the previously reported impairment of coronary flow reserve after CPB surgery could be due to increase in basal coronary flow after CPB. Off-pump coarctectomy seems to have little impact on CF, as the postsurgical decline in flow in these patients seems to relate to the reduction in cardiac pressure afterload.

congenital heart disease; coronary blood flow; cardiopulmonary bypass surgery