title: [Importance of the heart-brain binomial in the management of congenital heart disease].
abstract: A case of a two month infant with complex congenital heart disease (aortic coarctation with ventricular septal defect) associated to a cellular brain migration failure is presented. The management strategy consisted on the correction of congenital heart disease by means of a two-stage surgery without a further preoperative evaluation of the neurological status. The patient developed several perioperative complications such as two episodes of cardiac arrest, reconnection to cardiopulmonary bypass, cardiac tamponade, chilothorax and septic shock. A neurological protocol consisting in electroencephalography, brain magnetic resonance and Single Photon Emission Computed Tomography (SPECT) was practiced during the postoperative period, which detected microgyria with paquigyria and a cellular brain migration failure was suspected. The final outcome was death due to multisystemic failure and the autopsy confirmed the neurological disease, as well as poor life function prognosis. Should the heart-brain binomial had been considered in an integral preoperative evaluation, the therapeutical approach could have been modified.
authors.affiliation: Departamento de Cardiología Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Pando-Orellana
authors.forename: Alfonso
authors.initials: A
authors.lastname: Buendía-Hernández
authors.forename: Juan
authors.initials: J
authors.lastname: Calderón-Colmenero
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Razo-Pinete
authors.forename: Emilia J
authors.initials: EJ
authors.lastname: Patiño
authors.forename: Jorge Luis
authors.initials: JL
authors.lastname: Cervantes-Salazar
authors.forename: Aloha
authors.initials: A
authors.lastname: Meave-González
authors.forename: David
authors.initials: D
authors.lastname: Bialostozky
authors.forename: Iván
authors.initials: I
authors.lastname: Corral-Mejorado
authors.forename: Pedro José
authors.initials: PJ
authors.lastname: Curi-Curi
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis*; D001921:Brain / Q000002:abnormalities* / Q000473:pathology; D017809:Fatal Outcome; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male