Transcranial Doppler Sonography in Children with Congenital Heart Disease Undergoing Cardiac Catheterization

Abstract

Background Children with congenital heart disease (CHD) are at high risk for neurodevelopmental disabilities. Acute neurologic complications, such as seizures, transient ischemic attack, intracranial hemorrhage, and ischemic stroke might occur in the setting of cardiac surgery and cardiac catheterization. Cardiac catheterization is important in the diagnosis and assessment of hemodynamic function in children with congenital heart disease. The incidence of neurologic complications (occurring within 48 hours) in interventional cardiac catheterization is significantly higher than those in diagnostic. Objective The Aim of this study is to evaluate the effect of cardiac catheterization on TCD Commented [RM1]: transcranial doppler (TCD) in children with congenital heart disease. Methods This is a prospective study. 40 children were enrolled; at Children’s hospital, Ain Shams University over 6 months. TCD parameters, clinical data, neurologic examination were done before and after cardiac catheterization. Results In the present study, 33 patients (82.5%) had interventional catheter and 7 (17.5%) had diagnostic catheter. Middle cerebral artery TCD parameters of the patients in the diagnostic group showed lower peak systolic (PS), and time average mean of the maximal velocities (TAMX), also called mean velocity, before catheterization and lower PS, end diastolic (ED), and TAMX post catheterization. All patients showed statistically significant lower TAMX post catheterization. Conclusion Cardiac catheterization lower middle cerebral artery time average mean of the maximal velocities in children with congenital heart disease. This impairment in blood flow might be a risk for cerebrovascular diseases in this population.