Determinants of neurological outcome in neonates with congenital heart disease following heart surgery

Kuhn, Viktoria; Carpenter, Jessica; Zurakowski, David; Reitz, J.G.; Tague, Lauren; Donofrio, Mary T.; Murnick, Jonathan; Axt-Fliedner, R; Limperopoulos, Catherine; Yerebakan, Can

doi:10.1038/s41390-020-1085-1

Cited by 21 publications

(30 citation statements)

References 37 publications

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“…11 Kuhn et al also could not find an association between brain injury score and outcome up to 2 years of age in a group with a rate of 53% preoperative J o u r n a l P r e -p r o o f lesions and 57% new postoperative lesions but with a low median brain injury severity at both timepoints. 58 Future studies are needed to explore the role of more advanced MRI analyses such as regional volumes, morphometrics, and diffusion tensor imaging on long-term neurodevelopment. The latest studies on diffusion tensor imaging have shown extensive persisting white matter changes 28,59,60 to be associated with neurodevelopmental outcome up to 30 months of age.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Course and Socioeconomic Status Predict Long-Term Neurodevelopment Better Than Perioperative Conventional Neuroimaging in Children with Congenital Heart Disease

Neukomm¹,

Ehrler²,

Feldmann³

et al. 2022

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

Perioperative Course and Socioeconomic Status Predict Long-Term Neurodevelopment Better Than Perioperative Conventional Neuroimaging in Children with Congenital Heart Disease

Neukomm¹,

Ehrler²,

Feldmann³

et al. 2022

The Journal of Pediatrics

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“…Quality, as assessed with the CASP checklists, was found to be sufficient in all included studies. Level of evidence was rated as level 3 for 17 studies 18,29–44 and level 4 for one study 45 …”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies reported findings from qualitative evaluation of the brain MRI scans 18,29–33,35–43 . Sixteen studies assessed prevalence of ischaemic stroke and/or infarction 18,29–41,44,45 .…”

Section: Resultsmentioning

confidence: 99%

Early brain magnetic resonance imaging findings and neurodevelopmental outcome in children with congenital heart disease: A systematic review

Dijkhuizen

Munck

Jonge

et al. 2023

Develop Med Child Neuro

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AimTo investigate the association between early brain magnetic resonance imaging (MRI) findings and neurodevelopmental outcome (NDO) in children with congenital heart disease (CHD).MethodA search for studies was conducted in Embase, Medline, Web of Science, Cochrane Central, PsycINFO, and Google Scholar. Observational and interventional studies were included, in which patients with CHD underwent surgery before 2 months of age, a brain MRI scan in the first year of life, and neurodevelopmental assessment beyond the age of 1 year.ResultsEighteen studies were included. Thirteen found an association between either quantitative or qualitative brain metrics and NDO: 5 out of 7 studies showed decreased brain volume was significantly associated with worse NDO, as did 7 out of 10 studies on brain injury. Scanning protocols and neurodevelopmental tests varied strongly.InterpretationReduced brain volume and brain injury in patients with CHD can be associated with impaired NDO, yet standardized scanning protocols and neurodevelopmental assessment are needed to further unravel trajectories of impaired brain development and its effects on outcome.

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“…Postoperative cognitive dysfunction (POCD) is a common neurological complication after cardiac surgery [ 11 ]. The high incidence of POCD greatly impacts patients' postoperative recovery and quality of life, often leading to increased mortality, delayed rehabilitation, increased other complications, and even permanent cognitive impairment [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Evaluation Value of Diffusion‐Weighted Imaging for Brain Injury in Patients after Deep Hypothermic Circulatory Arrest

Zhuang

Lin

et al. 2022

Contrast Media & Molecular Imaging

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Objective. Cerebral complications may occur after surgery with deep hypothermic circulatory arrest (DHCA). Diffusion-weighted imaging (DWI) has shown promising results in detecting early changes of cerebral ischemia. However, studies in human models are limited. Here, we examined the significance of DWI for detecting brain injury in postoperative patients after DHCA. Methods. Twelve patients who had undergone selective cerebral perfusion with DHCA were enrolled. All patients underwent magnetic resonance imaging (MRI) examinations before and after the operation with T1-weighted phase (T1W) and T2-weighted phase (T2W). Magnetic resonance angiography (3D TOF) was applied to observe intracranial arterial communication situations. DWI was employed to calculate the apparent diffusion coefficient (ADC) values. The neurocognitive function of patients was assessed preoperatively and postoperatively using the Montreal Cognitive Assessment Scale (MoCA), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA). Results. The ADC values of the whole brain of patients after surgery were significantly higher than before surgery (P = 0.003). However, no significant difference in the ADC values of other regions before and after the operation was observed. There was no significant effect on the postoperative cognitive function of patients after surgery, but visual-spatial and executive abilities were significantly reduced, while psychological anxiety (P = 0.005) and depression levels (P < 0.05) significantly increased. Correlation analysis revealed a significant association between ADC change values and depression change values (P < 0.05). Conclusion. DHCA demonstrated no significant effect on the cognitive function of patients but could affect the mood of patients. On the other hand, DWI demonstrated promising efficiency and accuracy in evaluating brain injury after DHCA.

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Determinants of neurological outcome in neonates with congenital heart disease following heart surgery

Cited by 21 publications

References 37 publications

Perioperative Course and Socioeconomic Status Predict Long-Term Neurodevelopment Better Than Perioperative Conventional Neuroimaging in Children with Congenital Heart Disease

Perioperative Course and Socioeconomic Status Predict Long-Term Neurodevelopment Better Than Perioperative Conventional Neuroimaging in Children with Congenital Heart Disease

Early brain magnetic resonance imaging findings and neurodevelopmental outcome in children with congenital heart disease: A systematic review

The Evaluation Value of Diffusion‐Weighted Imaging for Brain Injury in Patients after Deep Hypothermic Circulatory Arrest

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