Preoperative cranial ultrasound findings in infants with major congenital heart disease.

Autor: Te Pas AB; Division of Neonatology, Leiden University Medical Centre, Leiden, the Netherlands. a.b.te_pas@lumc.nl, van Wezel-Meijler G, Bökenkamp-Gramann R, Walther FJ
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2005 Nov; Vol. 94 (11), pp. 1597-603.
DOI: 10.1111/j.1651-2227.2005.tb01835.x
Abstrakt: Background: Advances in diagnostic testing and surgical techniques have resulted in reduced mortality in neonates with congenital heart disease (CHD) and a major concern for neurological morbidity in the presence of preoperative neurological injury.
Objectives: To determine the incidence and nature of preoperative cerebral ultrasound abnormalities in neonates with major CHD and to examine the relationship between cerebral abnormalities and the type of CHD.
Methods: Retrospective study; inclusion criteria: (1) neonates with major CHD admitted to the NICU over a 3-y period, (2) gestational age >35 wk, (3) documented preoperative cranial ultrasound available; exclusion criteria: (1) small for gestational age, (2) other congenital anomalies and/or chromosomal abnormalities, (3) a 5-min Apgar score <7, (4) congenital infection. Cranial ultrasounds (CUS) were reviewed without knowledge of the cardiac defect. CHDs were categorized.
Results: Fifty of 108 neonates with CHD met the inclusion criteria. Twenty-one patients (42%) had abnormalities on CUS. Thirteen of these (26%) had widened ventricular and/or subarachnoid spaces, three (6%) lenticulostriate vasculopathy, one (2%) calcification in the basal nuclei, and four (8%) had acute ischaemic changes. Cerebral abnormalities occurred more frequently in patients with coarctation or hypoplastic left heart syndrome (HLHS) than transposition of the great arteries (TGA) (63% vs 14%; n.s.).
Conclusion: There is a high incidence of preoperative cerebral ultrasound abnormalities in this group of neonates with major CHD.
Databáze: MEDLINE
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