ArticleJournal of the American College of Cardiology2023
Declining Incidence of Postoperative Neonatal Brain Injury in Congenital Heart Disease.
Article in Journal of the American College of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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22 citing papers in PubMed, 37 citations in OpenAlex.
- Brain injury in congenital heart disease: pathophysiology, MRI patterns, and perioperative risk factors.Pediatric research · 2026Review
- Environmental Exposures Influence Fetal Brain Growth and Risk of Neonatal Brain Injury in Congenital Heart Disease.Pediatric cardiology · 2026Article
- A simplified prediction model for in-hospital mortality in children with congenital heart disease after surgery.Translational pediatrics · 2026Article
- Clinical research study: cerebral autoregulation in neonates and infants undergoing open heart surgery: global patterns and derived cerebral hemodynamic metrics.Pediatric research · 2026Observational
- Early motor outcomes in infants with complex congenital heart disease: the predictive role of NSE and S100B.Pediatric research · 2026Article
- Perioperative Factors Associated with 2-Year Neurodevelopmental Outcome in Neonates Undergoing Congenital Cardiac Surgery with Cardiopulmonary Bypass: A Single-Center Cohort Study.Pediatric cardiology · 2026Article
- Advances in interdisciplinary care for term and preterm neonates with congenital heart disease: a narrative review.European journal of pediatrics · 2026Review
- Article
- Environmental Exposures Influence Fetal Brain Growth and Risk of Neonatal Brain Injury in Congenital Heart Disease.Research square · 2025Article
- 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
- Effect of Fetal Brain Oxygenation and Volume on Brain Maturation and Neurodevelopmental Outcomes in Congenital Heart Disease.Radiology · 2025Article
- Born too young or too blue tips the scaling of a folded brain.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Heart rate variability and cognitive functions in adolescents with complex congenital heart disease.Pediatric research · 2025Article
- Cerebral blood flow dynamics during cardiac surgery in infants.Pediatric research · 2025Article
- Preoperative Cerebral and Renal Saturations in Neonates with Congenital Heart Defects: A Prospective Cohort Study.Neonatology · 2025Article
- Assessment of Neurodevelopmental Outcomes in Children With Congenital Heart Disease Using Magnetic Resonance Imaging (MRI): Focus on Brain Volume as a Predictor of Neurodevelopmental Abnormalities.Journal of multidisciplinary healthcare · 2025Article
- Placental-Heart Axis: An Evolutionary Perspective.International journal of molecular sciences · 2024Review
- Postnatal Brain Trajectories and Maternal Intelligence Predict Childhood Outcomes in Complex CHD.Journal of clinical medicine · 2024Article
- Exploring the origins of neurodevelopmental proteasomopathies associated with cardiac malformations: are neural crest cells central to certain pathological mechanisms?Frontiers in cell and developmental biology · 2024Article
- Discovery and functional investigation ofAmerican journal of translational research · 2024Article
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundBrain injury is common in neonates with complex neonatal congenital heart disease (CHD) and affects neurodevelopmental outcomes.
objectivesGiven advancements in perioperative care, we sought to determine if the rate of preoperative and postoperative brain injury detected by using brain magnetic resonance imaging (MRI) and associated clinical risk factors have changed over time in complex CHD.
methodsA total of 270 term newborns with complex CHD were prospectively enrolled for preoperative and postoperative brain MRIs between 2001 and 2021 with a total of 466 MRI scans. Brain injuries in the form of white matter injury (WMI) or focal stroke and clinical factors were compared across 4 epochs of 5-year intervals with logistic regression.
resultsRates of preoperative WMI and stroke did not change over time. After adjusting for timing of the postoperative MRI, site, and cardiac group, the odds of newly acquired postoperative WMI were significantly lower in Epoch 4 compared with Epoch 1 (OR: 0.29; 95% CI: 0.09-1.00; P = 0.05). The adjusted probability of postoperative WMI declined significantly by 18.7% from Epoch 1 (24%) to Epoch 4 (6%). Among clinical risk factors, lowest systolic, mean, and diastolic blood pressures in the first 24 hours after surgery were significantly higher in the most recent epoch.
conclusionsThe prevalence of postoperative WMI has declined, whereas preoperative WMI rates remain constant. More robust postoperative blood pressures may explain these findings by minimizing periods of ischemia and supporting cerebral perfusion. These results suggest potential modifiable clinical targets in the postoperative time period to minimize the burden of WMI.
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