Evidence map›Paper›PMID 41906606›Full record

ArticleJACC. Advances2026

Preoperative Hemodynamics and Brain Injury in Transposition of the Great Arteries.

Devin Chetan, Thiviya Selvanathan, Fu-Tsuen Lee, Hanan Smaili, Min Bao, Jessie Mei Lim, Davide Marini, Amandeep Saini, Shabnam Peyvandi, Patrick McQuillen and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Devin ChetanDivision of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Division of Pediatric Cardiology, Lillehei Heart Institute, Masonic Children's Hospital, Minneapolis, Minnesota, USA; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Thiviya SelvanathanDepartment of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Fu-Tsuen LeeDivision of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Hanan SmailiDepartment of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Min BaoDepartment of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Jessie Mei LimDepartment of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Davide MariniDepartment of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Amandeep SainiDivision of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
Shabnam PeyvandiDivision of Pediatric Cardiology, Department of Pediatrics and Epidemiology & Biostatistics, Benioff Children's Hospital, University of California-San Francisco, San Francisco, California, USA.
Patrick McQuillenDivision of Critical Care, Department of Pediatrics, Benioff Children's Hospital, University of California-San Francisco, San Francisco, California, USA.
Helen M BransonDepartment of Diagnostic Imaging and Interventional Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Vann ChauDepartment of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Steven P MillerDepartment of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Mike SeedDivision of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Diagnostic Imaging and Interventional Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. Electronic address: mike.seed@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite improvements in transposition of the great arteries (TGA) outcomes, perinatal brain injury remains common.

objectivesThe purpose of this study was to document patterns of brain injury and to explore hemodynamic mechanisms of brain injury in a subset of patients using cardiovascular magnetic resonance (CMR).

methodsPreoperative brain magnetic resonance imaging and CMR were performed between 2014 and 2023. Brain injury was classified as stroke, white matter injury, or hypoxic ischemic injury. Spearman's correlation was used to assess relationships between hemodynamic parameters.

resultsNeuroimaging was obtained in 225/302 (74.5%) neonates with TGA, of whom 45/225 (20%) underwent CMR. Brain injury included arterial ischemic stroke (22/225; 9.8%), moderate-to-severe white matter injury (19/225; 8.4%), and hypoxic ischemic injury (6/225; 2.7%). Higher ratio of pulmonary to systemic blood flow (QpQs) was associated with lower superior vena cava flow and cerebral oxygen delivery but not cerebral blood flow. Higher QpQs was also associated with a higher ratio of cerebral blood flow to systemic blood flow. Hypoxic ischemic brain injuries occurred early due to a restrictive atrial septum or later, following pulmonary overcirculation.

conclusionsAlthough no clear association was found with brain injury, this study provides evidence that high QpQs is related to lower superior vena cava flow and cerebral oxygen delivery and may predispose infants with TGA to white matter injury and hypoxic ischemic injury. These findings suggest that to preserve cerebral blood flow, preoperative TGA patients who remain hypoxemic after balloon atrial septostomy may be better served by earlier arterial switch operation rather than attempting to increase patent ductus arteriosus size with prostaglandins. Our findings suggest hypoxic ischemic injury secondary to pulmonary overcirculation is also an important form of injury and may be preventable through judicious use of prostaglandin and timely surgical repair.

Indexed as

cardiac MRIcerebrovascular circulationheart-brainhemodynamicstransitional circulationtransposition of the great arteries

Identifiers

PMID41906606
PMCPMC13351995

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.