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Can preoperative cranial ultrasound predict early neurodevelopmental outcome in infants with congenital heart disease?


Latal, Beatrice; Kellenberger, Christian; Dimitropoulos, Anastasia; Hagmann, Cornelia; Balmer, Christian; Beck, Ingrid; Bernet, Vera (2015). Can preoperative cranial ultrasound predict early neurodevelopmental outcome in infants with congenital heart disease? Developmental Medicine and Child Neurology:639-644.

Abstract

AIM To determine the role of preoperative cranial ultrasound (cUS) in predicting neurodevelopmental outcome in infants undergoing bypass surgery for congenital heart disease (CHD). METHOD Prospective cohort study on 77 infants (44 males, 33 females) operated before 3 months of age (median age at surgery 10d [range 3-88d]) who received at least one preoperative cUS. Outcome at 1 year was assessed with a standardized neurological examination and the Bayley Scales of Infant Development II (mental developmental index [MDI]; psychomotor developmental index [PDI]). RESULTS Abnormalities on cUS were detected in 22 (29%) infants and consisted of diffuse brain oedema (n=12, 16%), periventricular white matter injury (n=5, 6%), ventricular dilatation (n=3, 4%), and intraventricular haemorrhage (IVH) (n=2, 3%). Infants undergoing balloon-atrial septostomy (BAS) had a higher rate of subsequent brain oedema than those without BAS (p=0.006). cUS abnormalities were not related to neurodevelopmental outcome. INTERPRETATION Preoperative cUS findings in infants undergoing bypass surgery for CHD occur rather frequently, consisting of mild lesions such as brain oedema or white matter changes. These findings, however, do not correlate with early neurodevelopmental outcome.

Abstract

AIM To determine the role of preoperative cranial ultrasound (cUS) in predicting neurodevelopmental outcome in infants undergoing bypass surgery for congenital heart disease (CHD). METHOD Prospective cohort study on 77 infants (44 males, 33 females) operated before 3 months of age (median age at surgery 10d [range 3-88d]) who received at least one preoperative cUS. Outcome at 1 year was assessed with a standardized neurological examination and the Bayley Scales of Infant Development II (mental developmental index [MDI]; psychomotor developmental index [PDI]). RESULTS Abnormalities on cUS were detected in 22 (29%) infants and consisted of diffuse brain oedema (n=12, 16%), periventricular white matter injury (n=5, 6%), ventricular dilatation (n=3, 4%), and intraventricular haemorrhage (IVH) (n=2, 3%). Infants undergoing balloon-atrial septostomy (BAS) had a higher rate of subsequent brain oedema than those without BAS (p=0.006). cUS abnormalities were not related to neurodevelopmental outcome. INTERPRETATION Preoperative cUS findings in infants undergoing bypass surgery for CHD occur rather frequently, consisting of mild lesions such as brain oedema or white matter changes. These findings, however, do not correlate with early neurodevelopmental outcome.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neonatology
04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:23 January 2015
Deposited On:06 Aug 2015 12:03
Last Modified:22 Nov 2017 00:29
Publisher:Mac Keith Press
ISSN:0012-1622
Publisher DOI:https://doi.org/10.1111/dmcn.12701
Official URL:http://onlinelibrary.wiley.com/doi/10.1111/dmcn.12701/epdf
PubMed ID:25614932

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