Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery
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 neurol...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2014-04, Vol.45 (4), p.625-632 |
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| container_title | European journal of cardio-thoracic surgery |
| container_volume | 45 |
| creator | Bertholdt, Sonia Latal, Beatrice Liamlahi, Rabia Prêtre, René Scheer, Ianina Goetti, Robert Dave, Hitendu Bernet, Vera Schmitz, Achim von Rhein, Michael Knirsch, Walter |
| description | 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. |
| doi_str_mv | 10.1093/ejcts/ezt422 |
| format | Article |
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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.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezt422</identifier><identifier>PMID: 24031043</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>Cardiopulmonary Bypass - statistics & numerical data ; Case-Control Studies ; Cerebral Cortex - blood supply ; Cerebral Cortex - pathology ; Cohort Studies ; Female ; Heart Defects, Congenital - surgery ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Preoperative Period ; Prospective Studies ; Stroke - pathology ; Treatment Outcome</subject><ispartof>European journal of cardio-thoracic surgery, 2014-04, Vol.45 (4), p.625-632</ispartof><rights>The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-400ca49eb1fe648977312be1c008c66d6afed74d1219d86e19be1f3f108157ec3</citedby><cites>FETCH-LOGICAL-c361t-400ca49eb1fe648977312be1c008c66d6afed74d1219d86e19be1f3f108157ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24031043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bertholdt, Sonia</creatorcontrib><creatorcontrib>Latal, Beatrice</creatorcontrib><creatorcontrib>Liamlahi, Rabia</creatorcontrib><creatorcontrib>Prêtre, René</creatorcontrib><creatorcontrib>Scheer, Ianina</creatorcontrib><creatorcontrib>Goetti, Robert</creatorcontrib><creatorcontrib>Dave, Hitendu</creatorcontrib><creatorcontrib>Bernet, Vera</creatorcontrib><creatorcontrib>Schmitz, Achim</creatorcontrib><creatorcontrib>von Rhein, Michael</creatorcontrib><creatorcontrib>Knirsch, Walter</creatorcontrib><creatorcontrib>Research Group Heart and Brain</creatorcontrib><creatorcontrib>on behalf of the Research Group Heart and Brain</creatorcontrib><title>Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>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.</description><subject>Cardiopulmonary Bypass - statistics & numerical data</subject><subject>Case-Control Studies</subject><subject>Cerebral Cortex - blood supply</subject><subject>Cerebral Cortex - pathology</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Preoperative Period</subject><subject>Prospective Studies</subject><subject>Stroke - pathology</subject><subject>Treatment Outcome</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQRi1ERUthxxp5BwvSjmM3Tpboij-pEhuQ2EWOMwmucuMwY4Muz9EHruktLFnNaOboaDSfEC8UXCjo9CXe-MSX-DuZun4kzlRrdWW1-fa49KCgsp2BU_GU-QYAGl3bJ-K0NqAVGH0mbndIOJBb5IIc4soyrnLv5hVT8JKQ4-pWjzKUWVhn6SMRLi6h_BXSd7kRxg3JpfAT5YqZ4hLn4IuOk0uZZVjLuDgSsszriDTHe42jMcQtL_uyo4McDptjlpxpRjo8EyeTWxifP9Rz8fX9uy-7j9X15w-fdm-vK68blSoD4J3pcFATNqbtrNWqHlB5gNY3zdi4CUdrRlWrbmwbVF1ZTnpS0Kori16fi9dH70bxR0ZO_T6wx2Vx5ebMvbqCtmlrDbagb46op8hMOPUblZ_QoVfQ_8mhv8-hP-ZQ8JcP5jzscfwH_318AV4dgZi3_6vuAGqomCM</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Bertholdt, Sonia</creator><creator>Latal, Beatrice</creator><creator>Liamlahi, Rabia</creator><creator>Prêtre, René</creator><creator>Scheer, Ianina</creator><creator>Goetti, Robert</creator><creator>Dave, Hitendu</creator><creator>Bernet, Vera</creator><creator>Schmitz, Achim</creator><creator>von Rhein, Michael</creator><creator>Knirsch, Walter</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140401</creationdate><title>Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery</title><author>Bertholdt, Sonia ; Latal, Beatrice ; Liamlahi, Rabia ; Prêtre, René ; Scheer, Ianina ; Goetti, Robert ; Dave, Hitendu ; Bernet, Vera ; Schmitz, Achim ; von Rhein, Michael ; Knirsch, Walter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-400ca49eb1fe648977312be1c008c66d6afed74d1219d86e19be1f3f108157ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Cardiopulmonary Bypass - statistics & numerical data</topic><topic>Case-Control Studies</topic><topic>Cerebral Cortex - blood supply</topic><topic>Cerebral Cortex - pathology</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Preoperative Period</topic><topic>Prospective Studies</topic><topic>Stroke - pathology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bertholdt, Sonia</creatorcontrib><creatorcontrib>Latal, Beatrice</creatorcontrib><creatorcontrib>Liamlahi, Rabia</creatorcontrib><creatorcontrib>Prêtre, René</creatorcontrib><creatorcontrib>Scheer, Ianina</creatorcontrib><creatorcontrib>Goetti, Robert</creatorcontrib><creatorcontrib>Dave, Hitendu</creatorcontrib><creatorcontrib>Bernet, Vera</creatorcontrib><creatorcontrib>Schmitz, Achim</creatorcontrib><creatorcontrib>von Rhein, Michael</creatorcontrib><creatorcontrib>Knirsch, Walter</creatorcontrib><creatorcontrib>Research Group Heart and Brain</creatorcontrib><creatorcontrib>on behalf of the Research Group Heart and Brain</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bertholdt, Sonia</au><au>Latal, Beatrice</au><au>Liamlahi, Rabia</au><au>Prêtre, René</au><au>Scheer, Ianina</au><au>Goetti, Robert</au><au>Dave, Hitendu</au><au>Bernet, Vera</au><au>Schmitz, Achim</au><au>von Rhein, Michael</au><au>Knirsch, Walter</au><aucorp>Research Group Heart and Brain</aucorp><aucorp>on behalf of the Research Group Heart and Brain</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>45</volume><issue>4</issue><spage>625</spage><epage>632</epage><pages>625-632</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><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.</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>24031043</pmid><doi>10.1093/ejcts/ezt422</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1010-7940 |
| ispartof | European journal of cardio-thoracic surgery, 2014-04, Vol.45 (4), p.625-632 |
| issn | 1010-7940 1873-734X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1508682307 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Cardiopulmonary Bypass - statistics & numerical data Case-Control Studies Cerebral Cortex - blood supply Cerebral Cortex - pathology Cohort Studies Female Heart Defects, Congenital - surgery Humans Infant, Newborn Magnetic Resonance Imaging Male Preoperative Period Prospective Studies Stroke - pathology Treatment Outcome |
| title | Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery |
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