title: Changes of brain magnetic resonance imaging findings after congenital aortic arch anomaly repair using regional cerebral perfusion in neonates and young infants.
abstract: BACKGROUND
  The objective of this prospective study is to compare magnetic resonance imaging (MRI) findings before and after surgery for repairing congenital aortic arch anomalies using regional cerebral perfusion.
  
  
  METHODS
  Neurologic examinations that included brain MRI, brain sonography, and electroencephalograms were performed before and after surgery for congenital aortic arch anomalies and the accompanying intracardiac anomalies using regional cerebral perfusion in 11 neonates and young infants.
  
  
  RESULTS
  The median age at operation was 11 days (range, 5 to 46). The diagnoses included coarctation of the aorta with accompanying intracardiac anomalies (n = 10) and interruption of the aortic arch (n = 1). Aortic arch repair was performed using regional cerebral perfusion through the right innominate artery (regional perfusion time: 25.6 ± 6.0 minutes) without cardiac arrest. Two patients had new postoperative lesions on postoperative brain MRI, and these were acute focal subdural hemorrhage (n = 1) and acute focal infarction (n = 1). However, they were without clinical significance. Periventricular leukomalacia was not observed on brain MRI. There was no significant change between the preoperative and postoperative findings on brain sonography and electroencephalograms. All the patients showed normal neurologic growth for a mean follow-up duration of 175.3 days (range: 25 to 497 days).
  
  
  CONCLUSIONS
  There were newly developed lesions on the postoperative brain MRI in 2 of 11 patients, even though these patients showed normal brain sonography and electroencephalogram findings and normal neurologic development. Our regional cerebral perfusion protocol for aortic arch repair showed tolerable neurologic outcomes, and it did not induce periventricular leukomalacia.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon, Korea.
authors.forename: Jae Gun
authors.initials: JG
authors.lastname: Kwak
authors.forename: Woong-Han
authors.initials: WH
authors.lastname: Kim
authors.forename: Jin Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: In-One
authors.initials: IO
authors.lastname: Kim
authors.forename: Jong-Hee
authors.initials: JH
authors.lastname: Chae
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D001018:Aortic Diseases / Q000151:congenital / Q000601:surgery*; D001921:Brain / Q000098:blood supply* / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004453:Echoencephalography; D004569:Electroencephalography; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D054079:Vascular Malformations / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*