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Eileen Broomall, MD, Mary E. McBride, MD, Barbara J

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Presentation on theme: "Eileen Broomall, MD, Mary E. McBride, MD, Barbara J"— Presentation transcript:

1 Posterior Circulation Ischemia or Occlusion in Five Adults With Failing Fontan Circulation 
Eileen Broomall, MD, Mary E. McBride, MD, Barbara J. Deal, MD, Laurence Ducharme-Crevier, MD, Alexandra Shaw, MD, Mjaye Mazwi, MD, Carl L. Backer, MD, Michael C. Mongé, MD, John Costello, MD, Bradley S. Marino, MD, MSCE, Andrew DeFreitas, MD, Mark S. Wainwright, MD, PhD  The Annals of Thoracic Surgery  Volume 101, Issue 6, Pages (June 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Imaging and physiologic recording for patient 1. (A) Anatomy of patient 1 showing Fontan palliation and relevant hemodynamic measurements from the preoperative catheterization. Of note are the elevated central venous pressures with mean values of 19 to 20 mm Hg. (B) Continuous recording of central venous pressure (CVP; upper panel) and arterial blood pressure (ABP; lower panel). Arrows show onset of symptoms of discomfort and agitation (first arrow) and quadriplegia (second arrow). Note the sustained elevation in central venous pressure and reduction in arterial blood pressure with the loss of motor function. (C) Axial noncontrast head computed tomography showing encephalomalacia in the left cerebellar hemisphere. (D) Coronal computed tomography two-dimensional angiogram showing the first visualization of the vertebral arteries (arrows) at approximately C5 (E). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Cerebrovascular imaging for patients 4 and 5. (A) Magnetic resonance angiogram of the head and neck of patient 4 showing occlusion of the proximal left vertebral artery. (B) Computed tomography angiogram of patient 4 showing absence of the left vertebral artery. (C) Computed tomography angiogram of patient 5 showing a small, atrophic left vertebral artery compared with the right vertebral artery (arrows). (D) Transcranial Doppler study of the left vertebral artery in patient 5 showing retrograde flow. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

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