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Titolo:
Patent foramen ovale and brain microembolization during scoliosis surgery in adolescents
Autore:
Rodriguez, RA; Sinclair, B; Weatherdon, D; Letts, M;
Indirizzi:
Univ Ottawa, Inst Heart, Div Cardiac Anethesia, Ottawa, ON K1Y 4W7, CanadaUniv Ottawa Ottawa ON Canada K1Y 4W7 nethesia, Ottawa, ON K1Y 4W7, Canada Childrens Hosp Eastern Ontario, Dept Surg, Div Orthoped, Ottawa, ON K1H 8L1, Canada Childrens Hosp Eastern Ontario Ottawa ON Canada K1H 8L1 N K1H 8L1, Canada Childrens Hosp Eastern Ontario, Dept Surg, Div Cardiovasc, Ottawa, ON K1H 8L1, Canada Childrens Hosp Eastern Ontario Ottawa ON Canada K1H 8L1 N K1H 8L1, Canada Childrens Hosp Eastern Ontario, Dept Pediat, Div Cardiol, Ottawa, ON K1H 8L1, Canada Childrens Hosp Eastern Ontario Ottawa ON Canada K1H 8L1 N K1H 8L1, Canada
Titolo Testata:
SPINE
fascicolo: 15, volume: 26, anno: 2001,
pagine: 1719 - 1721
SICI:
0362-2436(20010801)26:15<1719:PFOABM>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
DUCHENNE MUSCULAR-DYSTROPHY; PARADOXICAL EMBOLISM; FAT-EMBOLISM; COMPLICATIONS;
Keywords:
cerebral circulation; children; scoliosis; spine surgery; transcranial Doppler;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Rodriguez, RA Univ Ottawa, Inst Heart, Div Cardiac Anethesia, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada Univ Ottawa 40 Ruskin St Ottawa ON Canada K1Y 4W7 W7, Canada
Citazione:
R.A. Rodriguez et al., "Patent foramen ovale and brain microembolization during scoliosis surgery in adolescents", SPINE, 26(15), 2001, pp. 1719-1721

Abstract

Study Design. A case series is reported. Objective. To improve understanding of the potential mechanisms associatedwith cerebral microemboli during scoliosis surgery in adolescents. Summary of Background Data. Paradoxical cerebral fat microembolization during scoliosis surgery has been associated with right-to-left shunting through an undetected patent foramen ovale. The prevalence of this cardiac defect in the adult population may be as high as 15% to 25%. Although the clinical relevance of this embolic phenomenon during scoliosis surgery has not been investigated, a few reports have documented its fatal consequences. It has been suspected in some patients with postoperative reduced visual function, particularly after complex instrumented fusions. Methods. Bilateral transcranial Doppler (2 MHz) was used to monitor cerebral microemboli in the right and left middle cerebral arteries during spinalinstrumentation and fusion in four patients. Additionally, transthoracic or transesophageal echocardiography incorporating pulse and color Doppler (3.5-5 MHz) and a contrast test was used in these patients to detect atrial shunts. Results. Intraoperative transcranial Doppler monitoring detected high rates of cerebral microemboli associated with the presence of an atrial communication in two adolescents. In two additional patients with no detected brain microembolization, echocardiographic examination indicated the absence ofan atrial shunt. Conclusion. The study findings suggest that unrecognized atrial communications in adolescents undergoing scoliosis surgery contribute to higher ratesof Doppler-detected cerebral microemboli than those found in adolescents without this congenital defect.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/04/20 alle ore 23:47:41