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Pediatric Cardiology

, Volume 37, Issue 6, pp 1141–1147 | Cite as

Cerebral Microemboli Detection and Differentiation During Transcatheter Closure of Patent Ductus Arteriosus

  • Sean WallaceEmail author
  • Gaute Døhlen
  • Henrik Holmstrøm
  • Christian Lund
  • David Russell
Original Article
  • 208 Downloads

Abstract

The aim of this prospective study was to determine the frequency and composition of cerebral microemboli in a pediatric population, during transcatheter closure of patent ductus arteriosus (PDA). Multifrequency transcranial Doppler was used to monitor cerebral blood flow velocity (CBFV) and detect microembolic signals (MES) in the middle cerebral artery in 23 patients (median age 18 months). MES were automatically identified and differentiated according to composition; gaseous or solid. The procedure was divided into five periods: Arterial catheterization; venous catheterization; ductal catheterization; angiography; device placement and release. Timing of catheter manipulations and MES were registered and compared. MES were detected in all patients. The median number of signals was 7, (minimum 1, maximum 28). Over 95 % of all MES were gaseous. 11 % were detected during device placement while 64 % were detected during angiographic studies, significantly higher than during any other period (P < 0.001). There was a moderate correlation between the number of MES and volume of contrast used, (R = 0.622, P < 0.01). There was no correlation with fluoroscopic time or duration of procedure. This is the first study to investigate the timing and composition of cerebral microemboli during PDA occlusion. Microemboli were related to specific catheter manipulations and correlated with the amount of contrast used.

Keywords

Patent ductus arteriosus Interventional catheterization Transcranial Doppler Systemic emboli 

Notes

Funding

Dr. Wallace received a research Grant from the Norwegian Foundation for Health and Rehabilitation.

Compliance with Ethical Standards

Conflicts of interest

None.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Paediatric CardiologyRikshospitaletOsloNorway
  2. 2.Department of NeurologyRikshospitaletOsloNorway

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