title: Asymptomatic subclavian steal syndrome in children following cardiac surgery: a potential hazard with re-operation?
abstract: We describe a case of fatal hypoxic-ischemic encephalopathy, leading to brain death following the modified Fontan procedure in a child with asymptomatic subclavian steal syndrome (SSS). This patient's brain death was most likely multifactorial in view of his postoperative course. However, we believe that the presence of the SSS contributed to the abnormal cerebral circulation during surgery and postoperatively, leading to brain death. The presence of SSS in patients undergoing an open-heart procedure may be a risk factor for cerebral ischemia or brain death.
authors.affiliation: Department of Pediatrics, University of Alberta Hospitals, Edmonton, Canada.
authors.forename: M O
authors.initials: MO
authors.lastname: Gayle
authors.forename: C A
authors.initials: CA
authors.lastname: Ryan
authors.forename: K
authors.initials: K
authors.lastname: Pauw
authors.forename: P
authors.initials: P
authors.lastname: Penkoske
mesh_terms: D000792:Angiography; D001926:Brain Death / Q000473:pathology; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*