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Cerebral ultrasonography before and after cardiac surgery in infants
Insights
Cerebral ultrasound scans in infants undergoing open heart surgery reveal potential complications like ventriculomegaly and hemorrhage. Some initially normal scans can worsen post-operation, especially in complex cases.
Area of Science:
- Pediatric Cardiology
- Pediatric Neurology
- Medical Imaging
Background:
- Open heart surgery in infants is associated with risks.
- Cerebral complications can arise post-cardiac surgery.
- Early detection of neurological issues is crucial for infant outcomes.
Purpose of the Study:
- To assess the incidence of cerebral complications using ultrasonography in infants before and after open heart surgery.
- To identify risk factors associated with postoperative neurological changes.
Main Methods:
- Cerebral ultrasonography was performed on 66 infants pre- and post-open heart surgery.
- Infants had various congenital cardiac malformations.
- Follow-up scans were conducted up to 4 weeks post-operation.
Main Results:
- Preoperatively, 60/66 infants had normal brain ultrasounds; 6 showed minor abnormalities or ventriculomegaly.
- Postoperatively, 46 infants had normal scans; 5 showed severe ventriculomegaly with atrophy, and 4 had intracerebral hemorrhage.
- Initially normal scans converted to abnormal in some infants up to 4 weeks post-surgery.
Conclusions:
- Cerebral ultrasonography is valuable for monitoring infants after open heart surgery.
- Complex cardiac malformations and severe postoperative issues increase the risk of neurological deterioration.
- Prompt identification and management of cerebral complications are vital for improving outcomes in pediatric cardiac surgery patients.
Abstract:
Cerebral ultrasonography was performed in 66 infants before and after open heart surgery in order to study the incidence of cerebral complications. The underlying cardiac malformations were ventricular septal defect (n = 28), transposition of the great arteries (n = 11), tetralogy of Fallot (n = 8), complete atrioventricular septal defect (n = 5), total anomalous pulmonary venous drainage (n = 3), truncus arteriosus communis (n = 2), and complex cardiac malformations (n = 9). In 60 of the 66 infants ultrasonography of the brain preoperatively was normal, 3 had minor structural abnormalities, and 3 had ventriculomegaly of various degrees. Postoperatively, 46 infants had a normal brain ultrasound scan; 6 had slight structural abnormalities; and 5 had slight symmetric or asymmetric widening of the ventricles. Five infants showed severe ventriculomegaly with cerebral atrophy, and in 4 patients there was intracerebral hemorrhage, associated in 2 cases with severe ventriculomegaly. On repeat examinations it was found that up to 4 weeks after the operation an initially normal cerebral ultrasound scan could convert to a pathologic one. Most of those children who showed significant deterioration on the cerebral ultrasound scan suffered from complex cardiac malformations or had severe problems during the postoperative period.