ArticleStroke2022
Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration.
Article in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Risk of stroke in patients with congenital heart disease: a systematic review and meta-analysis.BMC neurology · 2024Pooled it
- Population Pharmacokinetics and Target Attainment of Allopurinol and Oxypurinol Before, During, and After Cardiac Surgery with Cardiopulmonary Bypass in Neonates with Critical Congenital Heart Disease.Clinical pharmacokinetics · 2024Trial
- Preoperative brain injury and neurodevelopmental outcomes in syndromic and non-syndromic children with complex congenital heart disease: a single-centre cohort study.European journal of pediatrics · 2026Article
- Brain injury in congenital heart disease: pathophysiology, MRI patterns, and perioperative risk factors.Pediatric research · 2026Review
- Surgical Timing, Preoperative Oxygenation, and Sex Are Associated with Oxidative Stress and αMedical sciences (Basel, Switzerland) · 2026Article
- Academic Achievements in Adolescents With Congenital Heart Disease: A Total Population-Based Cohort Study.Journal of the American Heart Association · 2026Article
- Intraoperative sodium range affects white matter microstructure in neonatal congenital heart disease.International journal of cardiology. Congenital heart disease · 2026Article
- Long-Term Outcome Following Prenatal Diagnosis of Transposition of the Great Arteries.Pediatric cardiology · 2026Article
- Quantitative Electroencephalogram Patterns During Neonatal Antegrade Cerebral Perfusion and Deep Hypothermic Circulatory Arrest that Suggest Neurologic Injury.Pediatric cardiology · 2026Article
- The Sooner, the Better: Neuroprotective Strategies in Fetuses With Congenital Heart Disease.Prenatal diagnosis · 2026Review
- From toddler to school age: longitudinal motor and cognitive outcomes in children with critical congenital heart disease.Frontiers in pediatrics · 2026Article
- Article
- The "Heart-and-Brain Interaction" in Newborns with Complex Congenital Heart Disease.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Article
- Congenital Heart Defects and Apgar Score at Birth, a Nationwide Study.Journal of the American Heart Association · 2025Article
- Perioperative Brain Injury in Children with Aortic Arch Anomalies: A Retrospective Study of Risk Factors and Outcomes.Pediatric cardiology · 2024Article
- Disrupted White Matter Topology Organization in Preschool Children with Tetralogy of Fallot.Brain and behavior · 2024Article
- Radiomics with structural magnetic resonance imaging, surface morphometry features, neurology scales, and clinical metrics to evaluate the neurodevelopment of preschool children with corrected tetralogy of Fallot.Translational pediatrics · 2024Article
- Effects of hemodynamic alterations and oxygen saturation on cerebral perfusion in congenital heart disease.Pediatric research · 2024Article
- Placental Pathology Contributes to Impaired Volumetric Brain Development in Neonates With Congenital Heart Disease.Journal of the American Heart Association · 2024Article
Corrections and comments
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Authors and funding
27 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundInfants with congenital heart disease are at risk of brain injury and impaired neurodevelopment. The aim was to investigate risk factors for perioperative brain lesions in infants with congenital heart disease.
methodsInfants with transposition of the great arteries, single ventricle physiology, and left ventricular outflow tract and/or aortic arch obstruction undergoing cardiac surgery <6 weeks after birth from 3 European cohorts (Utrecht, Zurich, and London) were combined. Brain lesions were scored on preoperative (transposition of the great arteries N=104; single ventricle physiology N=35; and left ventricular outflow tract and/or aortic arch obstruction N=41) and postoperative (transposition of the great arteries N=88; single ventricle physiology N=28; and left ventricular outflow tract and/or aortic arch obstruction N=30) magnetic resonance imaging for risk factor analysis of arterial ischemic stroke, cerebral sinus venous thrombosis, and white matter injury.
resultsPreoperatively, induced vaginal delivery (odds ratio [OR], 2.23 [95% CI, 1.06-4.70]) was associated with white matter injury and balloon atrial septostomy increased the risk of white matter injury (OR, 2.51 [95% CI, 1.23-5.20]) and arterial ischemic stroke (OR, 4.49 [95% CI, 1.20-21.49]). Postoperatively, younger postnatal age at surgery (OR, 1.18 [95% CI, 1.05-1.33]) and selective cerebral perfusion, particularly at ≤20 °C (OR, 13.46 [95% CI, 3.58-67.10]), were associated with new arterial ischemic stroke. Single ventricle physiology was associated with new white matter injury (OR, 2.88 [95% CI, 1.20-6.95]) and transposition of the great arteries with new cerebral sinus venous thrombosis (OR, 13.47 [95% CI, 2.28-95.66]). Delayed sternal closure (OR, 3.47 [95% CI, 1.08-13.06]) and lower intraoperative temperatures (OR, 1.22 [95% CI, 1.07-1.36]) also increased the risk of new cerebral sinus venous thrombosis.
conclusionsDelivery planning and surgery timing may be modifiable risk factors that allow personalized treatment to minimize the risk of perioperative brain injury in severe congenital heart disease. Further research is needed to optimize cerebral perfusion techniques for neonatal surgery and to confirm the relationship between cerebral sinus venous thrombosis and perioperative risk factors.
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