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- Publisher Website: 10.1016/S0003-4975(02)04627-1
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- PMID: 12645722
- WOS: WOS:000181431100041
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Article: Mesenteric blood flow response to feeding after systemic-to-pulmonary arterial shunt palliation
Title | Mesenteric blood flow response to feeding after systemic-to-pulmonary arterial shunt palliation |
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Authors | |
Issue Date | 2003 |
Publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur |
Citation | Annals Of Thoracic Surgery, 2003, v. 75 n. 3, p. 947-951 How to Cite? |
Abstract | Background. We hypothesized that the splanchnic circulation protects against diastolic steal through a systemic-to-pulmonary arterial shunt by reducing its resistance. To test the hypothesis we compared the basal and postprandial mesenteric blood flow velocities and vascular resistance in infants after shunt palliation for their underlying cyanotic heart disease with those in nonshunted infants. Methods. The basal and postprandial superior mesenteric arterial (SMA) time-average flow velocity (TAMV), end-diastolic flow velocity (EDFV), and relative resistance were assessed in 23 infants with congenital heart disease. The findings in the 9 shunted infants (group I) were compared with those in 14 nonshunted ones (group II). Results. In group II, TAMV (0.25 ± 0.07 versus 0.33 ± 0.09 m/s, p < 0.001) and EDFV (0.08 ± 0.04 versus 0.11 ± 0.04 m/s, p = 0.003) increased, while SMA relative resistance decreased (297 ± 121 versus 198 ± 73 mm Hg/ms-1, p < 0.001) postprandially. Similarly, in group I, TAMV (0.35 ± 0.13 versus 0.48 ± 0.19 m/s, p = 0.008) increased, while SMA relative resistance decreased (182 ± 61 versus 116 ± 38 mm Hg/ms-1, p = 0.005) after feeding. However, whereas basal and postprandial diastolic flow was antegrade in group II, absent or retrograde diastolic flow was characteristic of group I (preprandial, -0.10 ± 0.07 m/s; postprandial, -0.13 ± 0.06 m/s). Furthermore, group I had significantly lower SMA relative resistance both before (p = 0.02) and after (p = 0.006) feeding. Conclusions. Profound disturbance of splanchnic perfusion occurs in infants palliated with a systemic-to-pulmonary arterial shunt. Their basal and postprandial SMA diastolic blood flow is either absent or reversed. The lowering of basal and postprandial resistance of the splanchnic circulation probably represents an adaptive mechanism to counteract such diastolic steal. © 2003 by The Society of Thoracic Surgeons. |
Persistent Identifier | http://hdl.handle.net/10722/170325 |
ISSN | 2023 Impact Factor: 3.6 2023 SCImago Journal Rankings: 1.203 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
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dc.contributor.author | Cheung, YF | en_US |
dc.contributor.author | Ho, MHK | en_US |
dc.contributor.author | Cheng, VYW | en_US |
dc.date.accessioned | 2012-10-30T06:07:30Z | - |
dc.date.available | 2012-10-30T06:07:30Z | - |
dc.date.issued | 2003 | en_US |
dc.identifier.citation | Annals Of Thoracic Surgery, 2003, v. 75 n. 3, p. 947-951 | en_US |
dc.identifier.issn | 0003-4975 | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/170325 | - |
dc.description.abstract | Background. We hypothesized that the splanchnic circulation protects against diastolic steal through a systemic-to-pulmonary arterial shunt by reducing its resistance. To test the hypothesis we compared the basal and postprandial mesenteric blood flow velocities and vascular resistance in infants after shunt palliation for their underlying cyanotic heart disease with those in nonshunted infants. Methods. The basal and postprandial superior mesenteric arterial (SMA) time-average flow velocity (TAMV), end-diastolic flow velocity (EDFV), and relative resistance were assessed in 23 infants with congenital heart disease. The findings in the 9 shunted infants (group I) were compared with those in 14 nonshunted ones (group II). Results. In group II, TAMV (0.25 ± 0.07 versus 0.33 ± 0.09 m/s, p < 0.001) and EDFV (0.08 ± 0.04 versus 0.11 ± 0.04 m/s, p = 0.003) increased, while SMA relative resistance decreased (297 ± 121 versus 198 ± 73 mm Hg/ms-1, p < 0.001) postprandially. Similarly, in group I, TAMV (0.35 ± 0.13 versus 0.48 ± 0.19 m/s, p = 0.008) increased, while SMA relative resistance decreased (182 ± 61 versus 116 ± 38 mm Hg/ms-1, p = 0.005) after feeding. However, whereas basal and postprandial diastolic flow was antegrade in group II, absent or retrograde diastolic flow was characteristic of group I (preprandial, -0.10 ± 0.07 m/s; postprandial, -0.13 ± 0.06 m/s). Furthermore, group I had significantly lower SMA relative resistance both before (p = 0.02) and after (p = 0.006) feeding. Conclusions. Profound disturbance of splanchnic perfusion occurs in infants palliated with a systemic-to-pulmonary arterial shunt. Their basal and postprandial SMA diastolic blood flow is either absent or reversed. The lowering of basal and postprandial resistance of the splanchnic circulation probably represents an adaptive mechanism to counteract such diastolic steal. © 2003 by The Society of Thoracic Surgeons. | en_US |
dc.language | eng | en_US |
dc.publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur | en_US |
dc.relation.ispartof | Annals of Thoracic Surgery | en_US |
dc.subject.mesh | Blood Flow Velocity - Physiology | en_US |
dc.subject.mesh | Cardiac Output - Physiology | en_US |
dc.subject.mesh | Echocardiography, Doppler | en_US |
dc.subject.mesh | Enteral Nutrition | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Heart Defects, Congenital - Physiopathology - Surgery | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Infant | en_US |
dc.subject.mesh | Infant, Newborn | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Mesenteric Artery, Superior - Physiopathology | en_US |
dc.subject.mesh | Palliative Care | en_US |
dc.subject.mesh | Postprandial Period - Physiology | en_US |
dc.subject.mesh | Pulmonary Artery - Surgery | en_US |
dc.subject.mesh | Splanchnic Circulation - Physiology | en_US |
dc.subject.mesh | Ultrasonography, Doppler, Color | en_US |
dc.subject.mesh | Vascular Resistance - Physiology | en_US |
dc.title | Mesenteric blood flow response to feeding after systemic-to-pulmonary arterial shunt palliation | en_US |
dc.type | Article | en_US |
dc.identifier.email | Cheung, YF:xfcheung@hku.hk | en_US |
dc.identifier.authority | Cheung, YF=rp00382 | en_US |
dc.description.nature | link_to_subscribed_fulltext | en_US |
dc.identifier.doi | 10.1016/S0003-4975(02)04627-1 | en_US |
dc.identifier.pmid | 12645722 | - |
dc.identifier.scopus | eid_2-s2.0-0037336554 | en_US |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-0037336554&selection=ref&src=s&origin=recordpage | en_US |
dc.identifier.volume | 75 | en_US |
dc.identifier.issue | 3 | en_US |
dc.identifier.spage | 947 | en_US |
dc.identifier.epage | 951 | en_US |
dc.identifier.isi | WOS:000181431100041 | - |
dc.publisher.place | United States | en_US |
dc.identifier.scopusauthorid | Cheung, YF=7202111067 | en_US |
dc.identifier.scopusauthorid | Ho, MHK=8925896400 | en_US |
dc.identifier.scopusauthorid | Cheng, VYW=7005529517 | en_US |
dc.identifier.issnl | 0003-4975 | - |