The neonatal brain in critical congenital heart disease: Insights and future directions

• Published in: NeuroImage (Orlando, Fla.) Vol. 185; pp. 776 - 782
• Main Authors: Peyvandi, Shabnam, Latal, Beatrice, Miller, Steven P., McQuillen, Patrick S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.01.2019; Elsevier Limited
• Subjects: Brain development; Brain injury; Cardiovascular disease; Cognitive ability; Congenital diseases; Congenital heart disease; Coronary artery disease; Coronary vessels; Heart; Heart diseases; Heart surgery; Hemorrhage; Magnetic resonance imaging; Medical imaging; Neonates; Neurodevelopment; Neuroimaging; NMR; Nuclear magnetic resonance; Physiology; Pulmonary arteries; Risk factors; Surgery; Traumatic brain injury; Neurodevelopment; Congenital heart disease; Brain injury; Brain development
• ISSN: 1053-8119; 1095-9572
• DOI: 10.1016/j.neuroimage.2018.05.045

Neurodevelopmental outcomes are impaired in survivors of critical congenital heart disease (CHD) in several developmental domains including motor, cognitive and sensory outcomes. These deficits can extend into the adolescent and early adulthood years. The cause of these neurodevelopmental impairments is multi-factorial and includes patient specific risk factors, cardiac anatomy and physiology as well as brain changes seen on MRI. Advances in imaging techniques have identified delayed brain development in the neonate with critical CHD as well as acquired brain injury. These abnormalities are seen even before corrective neonatal cardiac surgery. This review focuses on describing brain changes seen on MRI in neonates with CHD, risk factors for these changes and the association with neurodevelopmental outcome. There is an emerging focus on the impact of cardiovascular physiology on brain health and the complex heart-brain interplay that influences ultimate neurodevelopmental outcome in these patients. •Neurodevelopmental outcome is impaired in survivors of critical congenital heart disease.•Advances in neonatal brain imaging have identified delayed brain development beginning in the third trimester of fetal life.•Acquired brain injury is common in critical congenital heart disease.•The relationship between brain imaging abnormalities in CHD and neurodevelopmental outcome is complex.