TY - JOUR
T1 - Antenatal and Perioperative Mechanisms of Global Neurological Injury in Congenital Heart Disease
AU - Barkhuizen, Melinda
AU - Abella, Raul
AU - Vles, J. S. Hans
AU - Zimmermann, Luc J. I.
AU - Gazzolo, Diego
AU - Gavilanes, Antonio W. D.
N1 - Funding Information:
This research was partially supported by the Sistema de Investigación y Desarrollo (SINDE) and the Vicerrectorado de Investigación y Posgrado of the Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
Funding Information:
This research was partially supported by the Sistema de Investigación y Desarrollo (SINDE) of the Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, through the Grant No. SIU- 319.
Funding Information:
This research was partially supported by the Sistema de Investigaci?n y Desarrollo (SINDE) and the Vicerrectorado de Investigaci?n?y Posgrado?of the Universidad Cat?lica de Santiago de Guayaquil, Guayaquil, Ecuador.
Publisher Copyright:
© 2020, The Author(s).
PY - 2021/1
Y1 - 2021/1
N2 - Congenital heart defects (CHD) is one of the most common types of birth defects. Thanks to advances in surgical techniques and intensive care, the majority of children with severe forms of CHD survive into adulthood. However, this increase in survival comes with a cost. CHD survivors have neurological functioning at the bottom of the normal range. A large spectrum of central nervous system dysmaturation leads to the deficits seen in critical CHD. The heart develops early during gestation, and CHD has a profound effect on fetal brain development for the remainder of gestation. Term infants with critical CHD are born with an immature brain, which is highly susceptible to hypoxic-ischemic injuries. Perioperative blood flow disturbances due to the CHD and the use of cardiopulmonary bypass or circulatory arrest during surgery cause additional neurological injuries. Innate patient factors, such as genetic syndromes and preterm birth, and postoperative complications play a larger role in neurological injury than perioperative factors. Strategies to reduce the disability burden in critical CHD survivors are urgently needed.
AB - Congenital heart defects (CHD) is one of the most common types of birth defects. Thanks to advances in surgical techniques and intensive care, the majority of children with severe forms of CHD survive into adulthood. However, this increase in survival comes with a cost. CHD survivors have neurological functioning at the bottom of the normal range. A large spectrum of central nervous system dysmaturation leads to the deficits seen in critical CHD. The heart develops early during gestation, and CHD has a profound effect on fetal brain development for the remainder of gestation. Term infants with critical CHD are born with an immature brain, which is highly susceptible to hypoxic-ischemic injuries. Perioperative blood flow disturbances due to the CHD and the use of cardiopulmonary bypass or circulatory arrest during surgery cause additional neurological injuries. Innate patient factors, such as genetic syndromes and preterm birth, and postoperative complications play a larger role in neurological injury than perioperative factors. Strategies to reduce the disability burden in critical CHD survivors are urgently needed.
KW - Congenital heart disease
KW - Hypoplastic left heart syndrome
KW - Immaturity
KW - Brain injury
KW - Surgery
KW - HYPOTHERMIC CIRCULATORY ARREST
KW - REGIONAL CEREBRAL PERFUSION
KW - WHITE-MATTER INJURY
KW - VENTRICULAR SEPTAL-DEFECT
KW - RANDOMIZED CLINICAL-TRIAL
KW - NEONATAL CARDIAC-SURGERY
KW - BIRTH-WEIGHT CHILDREN
KW - NEURODEVELOPMENTAL OUTCOMES
KW - CARDIOPULMONARY BYPASS
KW - BRAIN-INJURY
U2 - 10.1007/s00246-020-02440-w
DO - 10.1007/s00246-020-02440-w
M3 - (Systematic) Review article
C2 - 33373013
SN - 0172-0643
VL - 42
SP - 1
EP - 18
JO - Pediatric Cardiology
JF - Pediatric Cardiology
IS - 1
ER -