Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery.

Details

Serval ID
serval:BIB_1BAE2237E090
Type
Article: article from journal or magazin.
Collection
Publications
Title
Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery.
Journal
European Journal of Cardio-thoracic Surgery
Author(s)
Bertholdt S., Latal B., Liamlahi R., Prêtre R., Scheer I., Goetti R., Dave H., Bernet V., Schmitz A., von Rhein M., Knirsch W., Brain 
Working group(s)
Research Group Heart
Contributor(s)
Brain , Sennhauser FH., Plecko BR., Kretschmar O., Batinic K., Kellenberger C., Makki M., Isabel M., Bürki C., Weiss M., Hagmann C.
ISSN
1873-734X (Electronic)
ISSN-L
1010-7940
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
45
Number
4
Pages
625-632
Language
english
Notes
Publication types: Publication Status: ppublish
Abstract
OBJECTIVES: To determine the prevalence, spectrum and course of cerebral lesions in neonates with congenital heart disease (CHD) undergoing full flow cardiopulmonary bypass (CPB) surgery using magnetic resonance imaging (MRI) and to examine the correlation between cerebral lesions and clinical neurological abnormalities.
METHODS: Prospective cohort study of neonates with d-transposition of the great arteries (n = 22), univentricular heart malformation with hypoplastic aortic arch (n = 6) and aortic arch obstructions (n = 2) undergoing CPB. Neonates underwent cerebral MRI and blinded standardized neurological examination before (median day 6) and after surgery (day 13). The MRI findings were compared with those of 20 healthy controls.
RESULTS: Preoperative cerebral lesions were present in 7 of 30 patients (23%) with isolated mild or moderate white matter injury (WMI) (n = 4), isolated small cerebral stroke (n = 1) and combined WMI and stroke (n = 2). None of the healthy controls had cerebral lesions on MRI. CHD neonates with preoperative cerebral lesions had more neurological abnormalities (P = 0.01) than neonates without cerebral lesions. Low arterial oxygen saturation (P = 0.03) was a risk factor for preoperative cerebral lesions, while balloon atrioseptostomy (P = 0.19) was not. After surgery, preoperative cerebral lesions persisted in 5 of 7 neonates, and 2 neonates (7%) showed signs of additional WMI in their postoperative MRI.
CONCLUSIONS: In neonates with severe CHD, WMI was the predominant preoperative finding, while cerebral strokes were less frequent. New postoperative lesions were rare. Preoperative neurological abnormalities correlated with the presence of cerebral lesions on MRI.
Pubmed
Web of science
Open Access
Yes
Create date
16/12/2014 17:20
Last modification date
20/08/2019 12:52
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