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Preoperative cranial ultrasound findings in infants with major congenital heart disease
Author(s) -
TE PAS ARJAN B.,
WEZELMEIJLER GERDA,
BÖKENKAMPGRAMANN REGINA,
WALTHER FRANS J.
Publication year - 2005
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2005.tb01835.x
Subject(s) - medicine , hypoplastic left heart syndrome , heart disease , incidence (geometry) , gestational age , great arteries , pediatrics , subarachnoid hemorrhage , calcification , apgar score , retrospective cohort study , surgery , cardiology , pregnancy , physics , biology , optics , genetics
Background : Advances in diagnostic testing and surgical techniques have resulted in reduced mortality in neonates with congenital heart disease (CHD) and a major concern for neurological morbidity in the presence of preoperative neurological injury. Objectives : To determine the incidence and nature of preoperative cerebral ultrasound abnormalities in neonates with major CHD and to examine the relationship between cerebral abnormalities and the type of CHD. Methods: Retrospective study; inclusion criteria: (1) neonates with major CHD admitted to the NICU over a 3‐y period, (2) gestational age > 35 wk, (3) documented preoperative cranial ultrasound available; exclusion criteria: (1) small for gestational age, (2) other congenital anomalies and/or chromosomal abnormalities, (3) a 5‐min Apgar score < 7, (4) congenital infection. Cranial ultrasounds (CUS) were reviewed without knowledge of the cardiac defect. CHDs were categorized. Results: Fifty of 108 neonates with CHD met the inclusion criteria. Twenty‐one patients (42%) had abnormalities on CUS. Thirteen of these (26%) had widened ventricular and/or subarachnoid spaces, three (6%) lenticulostriate vasculopathy, one (2%) calcification in the basal nuclei, and four (8%) had acute ischaemic changes. Cerebral abnormalities occurred more frequendy in patients with coarctation or hypoplastic left heart syndrome (HLHS) than transposition of the great arteries (TGA) (63% vs 14%; n.s.). Conclusion: There is a high incidence of preoperative cerebral ultrasound abnormalities in this group of neonates with major CHD.