Hypoplastic A1 in child with complex heart defects

My daughter has Hhypoplastic right heart syndrome(single ventricle) and she's had several open heart surgeries. She's now 5yrs old. She has been experiencing bad headaches for a year now and they did a brain/spinal MRI/MRA everything looked good except for a hypoplastic artery in right side of brain(A1). There were no blood clots around it. She continues to have headaches so they are adjusting pain medication to control it. After all of this we saw the cardiologist and he suggested that it may have been caused by the Blalock-Taussig shunt and stenting may be needed.

How common is this hypo artery in association to the BT? Do you know if they usually stent a hypo A1 artery or leave it alone? I read that a hypoplastic A1 increases your risk of stroke. Is there anything they can do to cut those risks? Does low cardiac output cause headaches? We already know she has low cardiac output which causes dilated capillaries in her face(the headaches started about the same time as the bright red face).

Any info would be helpful as we are not scheduled to see the card or neuro for a couple of months. Thanks

[Nassim Abi Chahine, MD]

Low cardiac output may be the cause only if it is episodic and happening in a form of crisis of low CO, the arterial dilatation also may be a reaction to the low tissue oxygenation, but we should not think about, while the cardiac output is becoming better, consult the pediatrician to ajust the lower dose of effective valproate. when needed we can contact each other.

[HRHSmommy]

Thank you for responding. We saw the neurologist yesterday and he is adjusting the medication in order to relieve the headaches. After her neurologist and cardiologist discussed the situation, they determined that the shunt may in fact have caused the artery to be hypoplastic. They will not need to stent the artery at this time, but they may have to fix the shunt. I don't believe that she has crisis of low CO, but instead has chronic low cardiac output. So the headaches were not related to the cardiac output at all. We will also see the cardiologist again soon. If I have any further questions, I will direct them here. Thank you.