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Structural brain lesions in adolescents with congenital heart disease


von Rhein, M; Scheer, I; Loenneker, T; Huber, R; Knirsch, W; Latal, B (2011). Structural brain lesions in adolescents with congenital heart disease. Journal of Pediatrics, 158(6):984-989.

Abstract

Objectives To assess long-term neurodevelopmental outcome of adolescents with congenital heart disease after
open-heart surgery and to evaluate whether deficits are associated with cerebral injury detectable on magnetic resonance imaging (MRI). Study design We conducted a cohort study with longitudinal follow-up of 53 adolescents (mean age, 13.7 years; range, 11.4 to 16.9 years) who had undergone open-heart surgery with full-flow cardiopulmonary bypass during childhood and compared them with 41 age-matched controls. Assessment included conventional MRI and neurodevelopmental testing. Results MRI abnormalities were detected in 11 of the 53 patients (21%), comprising predominately white matter abnormalities and volume loss. Neurodevelopmental outcome was impaired in several domains, including neuromotor, intellectual, and executive functions, as well as visuomotor perception and integration. Adolescents with cerebral abnormalities had greater impairment in most neurodevelopmental domains compared with those without cerebral abnormalities.
Conclusions Cerebral abnormalities can be detected in a significant proportion of adolescents with corrected
congenital heart disease. These abnormalities are found predominately in the white matter and are apparently of
hypoxic-ischemic origin, most likely acquired during the neonatal period.

Abstract

Objectives To assess long-term neurodevelopmental outcome of adolescents with congenital heart disease after
open-heart surgery and to evaluate whether deficits are associated with cerebral injury detectable on magnetic resonance imaging (MRI). Study design We conducted a cohort study with longitudinal follow-up of 53 adolescents (mean age, 13.7 years; range, 11.4 to 16.9 years) who had undergone open-heart surgery with full-flow cardiopulmonary bypass during childhood and compared them with 41 age-matched controls. Assessment included conventional MRI and neurodevelopmental testing. Results MRI abnormalities were detected in 11 of the 53 patients (21%), comprising predominately white matter abnormalities and volume loss. Neurodevelopmental outcome was impaired in several domains, including neuromotor, intellectual, and executive functions, as well as visuomotor perception and integration. Adolescents with cerebral abnormalities had greater impairment in most neurodevelopmental domains compared with those without cerebral abnormalities.
Conclusions Cerebral abnormalities can be detected in a significant proportion of adolescents with corrected
congenital heart disease. These abnormalities are found predominately in the white matter and are apparently of
hypoxic-ischemic origin, most likely acquired during the neonatal period.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:28 Dec 2011 15:28
Last Modified:05 Apr 2016 15:13
Publisher:Elsevier
ISSN:0022-3476
Publisher DOI:https://doi.org/10.1016/j.jpeds.2010.11.040
PubMed ID:21237469

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