Structural brain lesions in adolescents with congenital heart disease.
OBJECTIVE
To assess long-term neurodevelopmental outcome of adolescents with congenital heart disease after open-heart surgery and to evaluate whether deficits are associated with cerebral injury detectable on magnetic resonance imaging (MRI).


METHODS
We conducted a cohort study with longitudinal follow-up of 53 adolescents (mean age, 13.7 years; range, 11.4 to 16.9 years) who had undergone open-heart surgery with full-flow cardiopulmonary bypass during childhood and compared them with 41 age-matched controls. Assessment included conventional MRI and neurodevelopmental testing.


RESULTS
MRI abnormalities were detected in 11 of the 53 patients (21%), comprising predominately white matter abnormalities and volume loss. Neurodevelopmental outcome was impaired in several domains, including neuromotor, intellectual, and executive functions, as well as visuomotor perception and integration. Adolescents with cerebral abnormalities had greater impairment in most neurodevelopmental domains compared with those without cerebral abnormalities.


CONCLUSIONS
Cerebral abnormalities can be detected in a significant proportion of adolescents with corrected congenital heart disease. These abnormalities are found predominately in the white matter and are apparently of hypoxic-ischemic origin, most likely acquired during the neonatal period.
Child Development Center, University Children's Hospital, Zurich, Switzerland.
Michael
M
von Rhein
Ianina
I
Scheer
Thomas
T
Loenneker
Reto
R
Huber
Walter
W
Knirsch
Beatrice
B
Latal
D000293:Adolescent; D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000150:complications*; D002315:Cardiopulmonary Bypass; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000150:complications; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D013903:Thoracic Surgery / Q000379:methods