• A Marc Harrison, Steve Davis, Janet R Reid, Stuart C Morrison, Susana Arrigain, Jason T Connor, and Mary E Temple.
• Department of Pediatric Critical Care Medicine, Children's Hospital, Cleveland Clinic Foundation, Cleveland, OH, USA.
• Pediatr Crit Care Me. 2005 Jul 1;6(4):445-7.

ObjectiveTo a) describe superior mesenteric artery resistive index, as an estimate of perfusion, before and after modified Norwood; and b) assess incidence of diastolic flow reversal in the superior mesenteric artery before and after modified Norwood.DesignProspective observational trial.SettingChildren's hospital pediatric intensive care unit.PatientsTen newborns with hypoplastic left heart syndrome.InterventionsUltrasound documentation of superior mesenteric artery diastolic flow direction and measurement of superior mesenteric artery resistive index 24-48 hrs before and 24-48 hrs after modified Norwood.Measurements And Main ResultsSeven males and three females were enrolled. There was no change between the superior mesenteric artery resistive index pre- vs. postoperatively-0.99 (95% confidence interval, 0.85, 1.12) vs. 1.07 (95% confidence interval, 1.0, 1.15) (p = .13). Incidence of retrograde diastolic blood flow in the superior mesenteric artery was not different pre- vs. postoperatively (70% vs. 50%, p = .41). No patients developed necrotizing enterocolitis and all survived to hospital discharge.ConclusionsUltrasound measurements in neonates with hypoplastic left heart syndrome suggest that superior mesenteric artery perfusion, as measured by resistive index, is impaired. Superior mesenteric artery diastolic flow reversal is common before and immediately after modified Norwood.

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