Can preoperative cranial ultrasound predict early neurodevelopmental outcome in infants with congenital heart disease?

Beatrice Latal; Christian Kellenberger; Anastasia Dimitropoulos; Cornelia Hagmann; Christian Balmer; Ingrid Beck; Vera Bernet

doi:10.1111/dmcn.12701

Can preoperative cranial ultrasound predict early neurodevelopmental outcome in infants with congenital heart disease?

Dev Med Child Neurol. 2015 Jul;57(7):639-644. doi: 10.1111/dmcn.12701. Epub 2015 Jan 23.

Authors

Beatrice Latal^{1

2}, Christian Kellenberger³, Anastasia Dimitropoulos¹, Cornelia Hagmann⁴, Christian Balmer⁵, Ingrid Beck¹, Vera Bernet^{2

6}

Affiliations

¹ Child Development Center, University Children's Hospital, Zurich, Switzerland.
² Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
³ Paediatric Radiology, University Children's Hospital, Zurich, Switzerland.
⁴ Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland.
⁵ Department of Cardiology, University Children's Hospital Zurich, Zurich, Switzerland.
⁶ Department of Paediatric Intensive Care and Neonatology, University Children's Hospital Zurich, Zurich, Switzerland.

PMID: 25614932
DOI: 10.1111/dmcn.12701

Abstract

Aim: To determine the role of preoperative cranial ultrasound (cUS) in predicting neurodevelopmental outcome in infants undergoing bypass surgery for congenital heart disease (CHD).

Method: Prospective cohort study on 77 infants (44 males, 33 females) operated before 3 months of age (median age at surgery 10d [range 3-88d]) who received at least one preoperative cUS. Outcome at 1 year was assessed with a standardized neurological examination and the Bayley Scales of Infant Development II (mental developmental index [MDI]; psychomotor developmental index [PDI]).

Results: Abnormalities on cUS were detected in 22 (29%) infants and consisted of diffuse brain oedema (n=12, 16%), periventricular white matter injury (n=5, 6%), ventricular dilatation (n=3, 4%), and intraventricular haemorrhage (IVH) (n=2, 3%). Infants undergoing balloon-atrial septostomy (BAS) had a higher rate of subsequent brain oedema than those without BAS (p=0.006). cUS abnormalities were not related to neurodevelopmental outcome.

Interpretation: Preoperative cUS findings in infants undergoing bypass surgery for CHD occur rather frequently, consisting of mild lesions such as brain oedema or white matter changes. These findings, however, do not correlate with early neurodevelopmental outcome.