Abnormal Brain Structure and Function in Newborns With Complex Congenital Heart Defects Before Open Heart Surgery: A Review of the Evidence
- 24 May 2011
- journal article
- review article
- Published by SAGE Publications in Journal of Child Neurology
- Vol. 26 (6), 743-755
- https://doi.org/10.1177/0883073811402073
Abstract
Newborns with complex congenital heart defects are at high risk for developing neurological abnormalities. It is important to understand the timing, progression, and extent of these abnormalities to better elucidate their potential impact on neurodevelopment, and their implications for early screening and intervention. This review synthesizes the recent literature describing neurological and neurobehavioral abnormalities observed in fetuses and newborns before cardiac surgery. A considerable proportion of newborns with complex congenital heart defects exhibit neurobehavioral and electrophysiological abnormalities preoperatively. Likewise, conventional neuroimaging studies reported that a high percentage of this population experienced brain injury. Advanced neuroimaging modalities indicated that fetuses showed delayed third trimester brain growth, and newborns showed impaired white matter maturation, reduced N-acetylaspartate, and increased lactate. These findings suggest a fetal or early postnatal onset of impaired brain growth and development. Consequently, reliable methods for early screening and subsequent developmental intervention must be implemented.Keywords
This publication has 55 references indexed in Scilit:
- Clinically silent preoperative brain injuries do not worsen with surgery in neonates with congenital heart diseaseThe Journal of Thoracic and Cardiovascular Surgery, 2010
- Brain Volume and Metabolism in Fetuses With Congenital Heart DiseaseCirculation, 2010
- Brain immaturity is associated with brain injury before and after neonatal cardiac surgery with high-flow bypass and cerebral oxygenation monitoringThe Journal of Thoracic and Cardiovascular Surgery, 2009
- Brain maturation is delayed in infants with complex congenital heart defectsThe Journal of Thoracic and Cardiovascular Surgery, 2009
- Preoperative Brain Injury in Transposition of the Great Arteries Is Associated With Oxygenation and Time to Surgery, Not Balloon Atrial SeptostomyCirculation, 2009
- Prenatal Head Growth and White Matter Injury in Hypoplastic Left Heart SyndromePediatric Research, 2008
- Patterns of use of educational and rehabilitation services at school age for children with congenitally malformed heartsCardiology in the Young, 2008
- Patient characteristics are important determinants of neurodevelopmental outcome at one year of age after neonatal and infant cardiac surgeryThe Journal of Thoracic and Cardiovascular Surgery, 2007
- Health and well-being of children with congenital cardiac malformations, and their families, following open-heart surgeryCardiology in the Young, 2006
- Long-term Neuromotor Outcome at School Entry of Infants with Congenital Heart Defects Requiring Open-heart SurgeryThe Journal of Pediatrics, 2006