Time to surgery and preoperative cerebral hemodynamics predict postoperative white matter injury in neonates with hypoplastic left heart syndrome  Jennifer M. Lynch, PhD, Erin M. Buckley, PhD, Peter J. Schwab, BS, Ann L. McCarthy, BBA, Madeline E. Winters, BA, David R. Busch, PhD, Rui Xiao, PhD, Donna A. Goff, MD, MS, Susan C. Nicolson, MD, Lisa M. Montenegro, MD, Stephanie Fuller, MD, J. William Gaynor, MD, Thomas L. Spray, MD, Arjun G. Yodh, PhD, Maryam Y. Naim, MD, Daniel J. Licht, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 148, Issue 5, Pages 2181-2188 (November 2014) DOI: 10.1016/j.jtcvs.2014.05.081 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Timeline of the study. Pre-Op, Preoperative; Post-Op, postoperative; MRI, magnetic resonance imaging. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2181-2188DOI: (10.1016/j.jtcvs.2014.05.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 An example of a small volume (left, 70.7 mm3; arrow) and a large volume (right, 7577.7 mm3; arrows) periventricular leukomalacia. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2181-2188DOI: (10.1016/j.jtcvs.2014.05.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Box plot demonstrating the significant (P = .0005) difference in volume of new or worsened postoperative periventricular leukomalacia (PVL) for those patients with a time to surgery of ≤4 days versus ≥5 days. Two outliers were removed to improve the visualization. One outlier was in the left group and had a PVL volume of 7577.7 mm3, and the other outlier was in the right group and had a PVL volume of 4981.5 mm3. These outliers were only removed from Figure 3 but not from the statistical analysis. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2181-2188DOI: (10.1016/j.jtcvs.2014.05.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Preoperative cerebral oxygenation as a function of the top left, time to surgery and top right, preoperative blood flow index (BFI). Preoperative oxygen extraction fraction as a function of the bottom left, time to surgery and bottom right, preoperative BFI. The solid line represents the best-fit line to the data (top left, R2 = 0.17, P = .03, slope = −2.7 ± 1.2; top right, R2 = 0.15, P = .05, slope = −3.0 ± 1.4; bottom left, R2 = 0.15, P = .05, slope = 0.02 ± 0.01; bottom right, R2 = 0.16, P = .05, slope = 0.03 ± 0.01). The gray ribbon denotes the 95% confidence interval for the mean cerebral tissue oxygen saturation (ScO2) or cerebral oxygen extraction fraction (OEF). The symbols represent whether the subject had acquired a large amount of new or worsened postoperative periventricular leukomalacia. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2181-2188DOI: (10.1016/j.jtcvs.2014.05.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions