Frequency, Predictors, and Neurologic Outcomes of Vaso-occlusive Strokes Associated With Cardiac Surgery in Children

Domi, Trish; Edgell, David; McCrindle, Brian W.; Williams, William G.; Chan, Anthony; MacGregor, Daune; Kirton, Adam; deVeber, Gabrielle

doi:10.1542/peds.2007-1459

Cited by 83 publications

(57 citation statements)

References 34 publications

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“…166 More than half of all children who experienced an arterial ischemic stroke in the perioperative period had persistent sensory or motor impairments, with hemiparesis being the most common finding. 78 These studies suggest that some degree of fine or gross motor impairment is common in survivors with complex CHD. Screening for fine and gross motor skill impairments in children with complex CHD should follow the current AAP guidelines 19 for the general pediatric population or be at the discretion of the medical care provider.…”

Section: Fine and Gross Motor Skillsmentioning

confidence: 98%

“…These central nervous system events may contribute to the presence of acute arterial ischemic strokes or cerebral venous sinus thromboses or to the increased prevalence of periventricular leukomalacia in neonates and children after surgery for CHD. [77][78][79] In addition, for newborns with complex CHD who underwent cardiac surgery during the neonatal period or early infancy, subsequent operations with CPB during infancy are associated with decreased mental and psychomotor developmental indices at 1 year of age. 80 …”

Section: Neonates or Infants Requiring Open Heart Surgery (Cyanotic Amentioning

confidence: 99%

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Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Marino¹,

Lipkin²,

Newburger³

et al. 2012

Circulation

1,311

1,156

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Background— The goal of this statement was to review the available literature on surveillance, screening, evaluation, and management strategies and put forward a scientific statement that would comprehensively review the literature and create recommendations to optimize neurodevelopmental outcome in the pediatric congenital heart disease (CHD) population. Methods and Results— A writing group appointed by the American Heart Association and American Academy of Pediatrics reviewed the available literature addressing developmental disorder and disability and developmental delay in the CHD population, with specific attention given to surveillance, screening, evaluation, and management strategies. MEDLINE and Google Scholar database searches from 1966 to 2011 were performed for English-language articles cross-referencing CHD with pertinent search terms. The reference lists of identified articles were also searched. The American College of Cardiology/American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. A management algorithm was devised that stratified children with CHD on the basis of established risk factors. For those deemed to be at high risk for developmental disorder or disabilities or for developmental delay, formal, periodic developmental and medical evaluations are recommended. A CHD algorithm for surveillance, screening, evaluation, reevaluation, and management of developmental disorder or disability has been constructed to serve as a supplement to the 2006 American Academy of Pediatrics statement on developmental surveillance and screening. The proposed algorithm is designed to be carried out within the context of the medical home. This scientific statement is meant for medical providers within the medical home who care for patients with CHD. Conclusions— Children with CHD are at increased risk of developmental disorder or disabilities or developmental delay. Periodic developmental surveillance, screening, evaluation, and reevaluation throughout childhood may enhance identification of significant deficits, allowing for appropriate therapies and education to enhance later academic, behavioral, psychosocial, and adaptive functioning.

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Section: Fine and Gross Motor Skillsmentioning

confidence: 98%

Section: Neonates or Infants Requiring Open Heart Surgery (Cyanotic Amentioning

confidence: 99%

Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Marino¹,

Lipkin²,

Newburger³

et al. 2012

Circulation

1,311

1,156

View full text Add to dashboard Cite

show abstract

“…3 Almost one third of pediatric patients with acute ischemic stroke have CHD. 4 Risk factors for stroke in this group include a prothrombotic condition, a mechanical valve and an acute illness at the time of the stroke. 5 The risk of peri-operative stroke increases in those patients with CHD who are older at the time of surgery and in those who undergo reoperation or have a longer duration of cardiopulmonary bypass.…”

mentioning

confidence: 99%

Outcome, incidence and risk factors for stroke after pediatric heart transplantation: An analysis of the International Society for Heart and Lung Transplantation Registry

Morgan

Manlhiot

McCrindle

et al. 2016

The Journal of Heart and Lung Transplantation

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“…or via a systemic venous clot through a right-to-left shunt from a septal defect, patent foramen ovale (PFO) or other source. These can be procedure-related secondary to cardiac surgery or catheterbased interventions [23,24]. Although surgical repair of the defect significantly lowers the recurrence risk, the risk remains nonetheless persistent for a few years [24], hence the authors tend to maintain most children safely on at least anti-platelet therapy for at least one year (Class IIa, level of evidence C) [2,3], although this is controversial.…”

Section: Cardiogenic Aismentioning

confidence: 99%

Current Concepts in Pediatric Stroke

2014

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Stroke is a relatively rare but rather significant cause of short- and long-term morbidity and mortality in children. It can be divided into three categories: arterial ischemic stroke (AIS), hemorrhagic stroke (HS) and cerebral sinovenous thrombosis (CSVT). This review focuses on AIS. The etiologies of pediatric AIS are diverse and different from those in adult stroke, chief among these being congenital heart disease, vasculopathies, hematological disorders and prothrombotic states. Additional factors might be related to the age group, ethnicity and geographic factors. Early recognition enables initiation of prompt therapy thereby reducing risk of further recurrence and complications.

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Frequency, Predictors, and Neurologic Outcomes of Vaso-occlusive Strokes Associated With Cardiac Surgery in Children

Abstract: The frequency of vaso-occlusive stroke in children with congenital heart disease undergoing cardiac surgery was 5.4 cases per 1000 children. Age, duration of bypass, and reoperation may be associated with stroke risk.

Cited by 83 publications

References 34 publications

Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Outcome, incidence and risk factors for stroke after pediatric heart transplantation: An analysis of the International Society for Heart and Lung Transplantation Registry

Current Concepts in Pediatric Stroke

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