Background: Children with congenital heart disease (CHD) remain at high risk for long-term neurodevelopmental disabilities. Acute neurologic complications, such as seizures, transient ischemic attack, intracranial hemorrhage, and ischemic stroke may occur in the setting of cardiac surgery and cardiac catheterization.
Objective: to evaluate the effect of cardiac catheterization on cerebral hemodynamics assessed by transcranial Doppler (TCD) sonography in children with congenital heart disease.
Methods: This was an observational cohort study included forty children aged from 1 month to 18 years who were scheduled for cardiac catheterization at Ain Shams University Children's hospital in the period from January 2020 to January 2021. Clinical data, neurologic examination and TCD parameters were done before and after cardiac catheterization.
Results: In the present study, 33 patients (82.5%) had interventional catheterization and 7 (17.5%) had diagnostic catheterization. A history of previous cardiac catheterization were found in 11 (27.5%), 4 (36.4%) had previous failed catheterization, 3 (27.3%) had previous diagnostic catheterization out of 40 patients;. Middle cerebral artery TCD parameters of the patients in the diagnostic group showed statistically significant lower peak systolic (PS), and time average mean of the maximal velocities (TAMX) pre catheterization and statistically significant lower PS, end diastolic, and TAMX post catheterization. All patients showed statistically significant lower TAMX post catheterization.
Conclusion: Transcranial Doppler sonography is a noninvasive physiologic monitor of cerebral hemodynamics that can be performed at the bedside. In our experience derangements in cerebral hemodynamics were recorded. However, the practical implications of these findings remain uncertain.