Neuroimaging findings in newborns with congenital heart disease prior to surgery: an observational study.
cardiac surgery
cardiology
imaging
neonatology
neurodevelopment
Journal
Archives of disease in childhood
ISSN: 1468-2044
Titre abrégé: Arch Dis Child
Pays: England
ID NLM: 0372434
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
18
01
2018
revised:
17
04
2019
accepted:
26
04
2019
pubmed:
28
6
2019
medline:
1
4
2020
entrez:
28
6
2019
Statut:
ppublish
Résumé
Neurodevelopmental impairment has become the most important comorbidity in infants with congenital heart disease (CHD). We aimed to (1) investigate the burden of brain lesions in infants with CHD prior to surgery and (2) explore clinical factors associated with injury. Prospective observational study. Single centre UK tertiary neonatal intensive care unit. 70 newborn infants with critical or serious CHD underwent brain MRI prior to surgery. Prevalence of cerebral injury including arterial ischaemic strokes (AIS), white matter injury (WMI) and intracranial haemorrhage. Brain lesions were observed in 39% of subjects (95% CI 28% to 50%). WMI was identified in 33% (95% CI 23% to 45%), subdural haemorrhage without mass effect in 33% (95% CI 23% to 45%), cerebellar haemorrhage in 9% (95% CI 4% to 18%) and AIS in 4% (95% CI 1.5% to 12%). WMI was distributed widely throughout the brain, particularly involving the frontal white matter, optic radiations and corona radiata. WMI exhibited restricted diffusion in 48% of cases. AIS was only observed in infants with transposition of the great arteries (TGA) who had previously undergone balloon atrial septostomy (BAS). AIS was identified in 23% (95% CI 8% to 50%) of infants with TGA who underwent BAS, compared with 0% (95% CI 0% to 20%) who did not. Cerebral injury in newborns with CHD prior to surgery is common.
Identifiants
pubmed: 31243012
pii: archdischild-2018-314822
doi: 10.1136/archdischild-2018-314822
pmc: PMC6801127
mid: EMS84277
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1042-1048Subventions
Organisme : Medical Research Council
ID : MR/L011530/1
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 203148
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/15/55/31649
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U120088465
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K006355/1
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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