Impaired neuroanatomic development in infants with congenital heart disease

Watanabe, Kazuhiro; Matsui, Mié; Matsuzawa, Junko; Tanaka, Chiaki; Noguchi, Kyo; Yoshimura, Naoki; Hongo, Kazuhisa; Ishiguro, Mayumi; Wanatabe, Sayaka; Hirono, Keiich; Uese, Keiichiro; Ichida, Fukiko; Origasa, Hideki; Nakazawa, Jin; Oshima, Yoshihiro; Miyawaki, Toshio; Matsuzaki, Tachiyo; Yagihara, Toshikatsu; Bilker, Warren B.; Gur, Ruben C.

doi:10.1016/j.jtcvs.2008.06.036

Cited by 58 publications

(63 citation statements)

References 35 publications

(34 reference statements)

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“…Watanabe et al, 23 however, described an association between reduced frontal gray matter volume and lower scores on the Bayley Psychomotor Developmental Index in older infants following corrective cardiac surgery. Similarly, there is a growing body of evidence suggesting an association between abnormal neurobehavior and reductions in specific brain tissue volumes in premature infants.…”

Section: Discussionmentioning

confidence: 99%

Brain Volume and Neurobehavior in Newborns with Complex Congenital Heart Defects

Owen

Shevell

Donofrio

et al. 2014

The Journal of Pediatrics

101

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Objective To investigate the relationship between tissue-specific alterations in brain volume and neurobehavioral status in newborns with complex congenital heart defects preoperatively. Study design Three-dimensional volumetric magnetic resonance imaging was used to calculate tissue-specific brain volumes and a standardized neurobehavioral assessment was performed to assess neurobehavioral status in 35 full-term newborns admitted to the hospital before cardiopulmonary bypass surgery. Multiple linear regression models were performed to evaluate relationships between neurobehavioral status and brain volumes. Results Reduced subcortical gray matter (SCGM) volume and increased cerebrospinal fluid (CSF) volume were associated with poor behavioral state regulation (SCGM, P = .04; CSF, P = .007) and poor visual orienting (CSF, P = .003). In cyanotic newborns, reduced SCGM was associated with higher overall abnormal scores on the assessment (P = .001) and poor behavioral state regulation (P = .04), and increased CSF volume was associated with poor behavioral state regulation (P = .02), and poor visual orienting (P = .02). Conversely, acyanotic newborns showed associations between reduced cerebellar volume and poor behavioral state regulation (P = .03). Conclusion Abnormal neurobehavior is associated with impaired volumetric brain growth before open heart surgery in infants with complex congenital heart defects. This study highlights a need for routine preoperative screening and early intervention to improve neurodevelopmental outcomes.

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Section: Discussionmentioning

confidence: 99%

Brain Volume and Neurobehavior in Newborns with Complex Congenital Heart Defects

Owen

Shevell

Donofrio

et al. 2014

The Journal of Pediatrics

101

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“…In late gestation, the transposed fetal circulation results in lower substrate delivery to the rapidly developing brain, which may account for the higher than expected incidence of microcephaly, white matter injury and cortical immaturity seen on neonatal MRI scans. Current data suggests that ND outcome will be better if children can be delivered at term [20–23]. It is recommended that coordination of maternal transfer begins soon after the fetal diagnosis is made for institutions that do not perform the ASO.…”

Section: Preoperative Carementioning

confidence: 99%

D-Transposition of the Great Arteries

Villafañe

Lantin‐Hermoso

Bhatt

et al. 2014

Journal of the American College of Cardiology

239

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Objectives This paper aims to update clinicians on “Hot Topics” in the management of patients with d-transposition of the great arteries (D-TGA) in the current surgical era. Background The arterial switch operation (ASO) has replaced atrial switch procedures for D-TGA and 90% of patients now reach adulthood. Methods The Adult Congenital and Pediatric Cardiology Council (ACPC) of the American College of Cardiology assembled a team of experts to summarize current knowledge on genetics, prenatal diagnosis, surgical timing, balloon atrial septostomy (BAS), prostaglandin therapy (PGE), intraoperative techniques, imaging, coronary obstruction, arrhythmias, sudden death, aortic dilation and regurgitation (AR), neurodevelopmental (ND) issues and lifelong care of D-TGA patients. Results In simple D-TGA, 1) familial recurrence risk is low; 2) children diagnosed prenatally have improved cognitive skills compared with those diagnosed postnatally; 3) echocardiography helps to identify risk factors; 4) routine use of BAS and PGE may not be beneficial in some cases; 5) early ASO improves outcomes and reduces costs with a low mortality. Single or intramural coronary arteries remain risk factors; 6) post-ASO arrhythmias and cardiac dysfunction should raise suspicion of coronary insufficiency; 7) coronary insufficiency and arrhythmias are rare but associated with sudden death; 8) early and late-onset ND abnormalities are common; 9) AR and aortic root dilation are well tolerated; and 10) the aging ASO patient may benefit from “exercise-prescription” rather than restriction. Conclusions Significant strides have been made in understanding risk factors for cardiac, ND and other important clinical outcomes after ASO.

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“…Advanced imaging techniques have also been used to evaluate the presence of brain injury or dysmaturity in fetuses and newborns with CHD. These studies have described impaired microstructure by DTI, 83,94 lower cerebral perfusion by MR arterial spin labeling, 95 smaller brain volumes by MR volumetric methods, 96,97 and altered cerebral metabolites (i.e., decreased NAA/ Cho 83 and increased Lac 87,89 and Lac/Cho 83,84 ) by MRS compared to non-CHD controls.…”

Section: Congenital Heart Diseasementioning

confidence: 99%

MRI for neurodevelopmental prognostication in the high-risk term infant

Massaro

2015

Seminars in Perinatology

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Impaired neuroanatomic development in infants with congenital heart disease

Cited by 58 publications

References 35 publications

Brain Volume and Neurobehavior in Newborns with Complex Congenital Heart Defects

Brain Volume and Neurobehavior in Newborns with Complex Congenital Heart Defects

D-Transposition of the Great Arteries

MRI for neurodevelopmental prognostication in the high-risk term infant

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