Comparable Cerebral Blood Flow in Both Hemispheres During Regional Cerebral Perfusion in Infant Aortic Arch Surgery André Rüffer, MD, Philip Tischer,

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Comparable Cerebral Blood Flow in Both Hemispheres During Regional Cerebral Perfusion in Infant Aortic Arch Surgery André Rüffer, MD, Philip Tischer, MD, Frank Münch, MCT, Ariawan Purbojo, MD, Okan Toka, MD, Wolfgang Rascher, MD, Robert Anton Cesnjevar, MD, Jörg Jüngert, MD The Annals of Thoracic Surgery Volume 103, Issue 1, Pages 178-185 (January 2017) DOI: 10.1016/j.athoracsur.2016.05.088 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Tomography imaging was performed in the transfontanellar coronary plane during (A) regional cerebral perfusion (three-dimensional color Doppler) and (B) total body perfusion (three-dimensional power Doppler). The Annals of Thoracic Surgery 2017 103, 178-185DOI: (10.1016/j.athoracsur.2016.05.088) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Three-dimensional imaging was performed with color Doppler during regional cerebral perfusion: (A) axial section; (B) glass-body rendering. The Annals of Thoracic Surgery 2017 103, 178-185DOI: (10.1016/j.athoracsur.2016.05.088) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Individual cerebral vessel imaging was performed with two-dimensional Doppler sonography during regional cerebral perfusion. (A) Transtemporal color and pulse-wave Doppler including angle correction: measurement of mean time average velocity (TAV) in right medial cerebral artery (MCA). (B) Transfontanellar parasagittal plane, color and pulse-wave Doppler: measurement of mean TAV in anterior cerebral artery (ACA). (C) Transfontanellar middle sagittal plane, power Doppler: basilar artery (BA) and communication with circle of Willis. (D) Transfontanellar coronary plane, color and pulse-wave Doppler: communicating circle of Willis. Red indicates antegrade flow in right internal carotid artery (ICA); blue indicates retrograde flow in left ICA, confirmed by pulse-wave Doppler. The Annals of Thoracic Surgery 2017 103, 178-185DOI: (10.1016/j.athoracsur.2016.05.088) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Cerebral time average velocity: total body perfusion (TBP) and regional cerebral perfusion (RCP). (Open bars = anterior cerebral artery [ACA] right; gray bars = ACA left; vertically striped bars = medial cerebral artery [MCA] right; horizontally striped bars = MCA left; light crossed bars = internal carotid artery [ICA] right; dark crossed bars = ICA left; crosshatched bars = basilar artery [BA]; circles indicate outliers; stars indicate extremes.) The Annals of Thoracic Surgery 2017 103, 178-185DOI: (10.1016/j.athoracsur.2016.05.088) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Cerebral regional cerebral oxygen saturation (rSO2): total body perfusion (TBP) and regional cerebral perfusion (RCP). (Solid bars = rSO2 right; open bars = rSO2 left; circle indicates outliers; stars indicate extremes.) The Annals of Thoracic Surgery 2017 103, 178-185DOI: (10.1016/j.athoracsur.2016.05.088) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions