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congenital cardiac diseases and brain

Ana L Neves, Tiago Henriques-Coelho, Adelino Leite-Moreira, José C Areias
OBJECTIVE: The aim of this article is to evaluate the clinical utility of brain natriuretic peptide in pediatric patients, examining the diagnostic value, management, and prognostic relevance, by critical assessment of the literature. DATA SOURCES: In December 2015, a literature search was performed (PubMed access to MEDLINE citations; and included these Medical Subject Headings and text terms for the key words: "brain natriuretic peptide," "amino-terminal pro-brain natriuretic peptide," "children," "neonate/s," "newborn/s," "infant/s," and "echocardiography...
September 30, 2016: Pediatric Critical Care Medicine
Qinghai Peng, Qichang Zhou, Ming Zang, Jiawei Zhou, Ran Xu, Tao Wang, Shi Zeng
OBJECTIVE: To screen and detect cortex gyration in fetuses with congenital heart disease (CHD) using Ultrasonography (US) during routine obstetric scans. METHODS: The depth of the Sylvian fissure (SF), parieto-occipital fissure (POF) and calcarine (CF) fissure were prospectively serially measured and compared in 45 fetuses with CHD and 45 normal fetuses. Cardiac hemodynamic parameters, including aortic valve diameter (AV), pulmonary valve diameter (PV), velocity time integral of the aortic valve (VTIav), and velocity time integral of the pulmonary valve (VTIpv), were recorded...
September 28, 2016: Prenatal Diagnosis
Volkan Coskun, Dawn M Lombardo
The cardiovascular and nervous systems are deeply connected during development, health, and disease. Both systems affect and regulate the development of each other during embryogenesis and the early postnatal period. Specialized neural crest cells contribute to cardiac structures, and a number of growth factors released from the cardiac tissue (e.g., glial cell line-derived neurotrophic factor, neurturin, nerve growth factor, Neurotrophin-3) ensure proper maturation of the incoming parasympathetic and sympathetic neurons...
December 2016: Journal of Neuroscience Research
Hongxiang Gao, Naipu Zhang, Fangfang Lu, Xindi Yu, Limin Zhu, Xi Mo, Wei Wang
OBJECTIVES: The objective of this study was to assess the perioperative changes in circulating histones and their relationships with other biomarkers and clinical outcomes after cardiac surgery with cardiopulmonary bypass (CPB) in patients. METHODS: Forty-eight patients with congenital cardiac diseases undergoing corrective procedure with CPB were prospectively enrolled in this study. Circulating histones, N-terminal pro-brain natriuretic peptide (NT-proBNP), procalcitonin (PCT) and C-reactive protein (CRP) were measured preoperatively (T0) and at 0 (T1), 24 (T2), 48 (T3) and 72 (T4) h postoperatively...
June 29, 2016: Interactive Cardiovascular and Thoracic Surgery
Bárbara Ribeiro, Joana Igreja, Miguel Gonçalves-Rocha, Alexandra Cadilhe
Goldenhar syndrome is a rare congenital disease associated with hemifacial hypoplasia as well as ear and ocular defects. Sometimes it is also associated with vertebral and other bone defects, cardiac malformations and central nervous system anomalies. Its aetiology is not yet clarified in the literature. We present a case of multiple malformations detected in the morphology ultrasound (at 22 weeks of gestation), namely absent nasal bones, micrognathia and absent left radius, among other defects. Genetic counselling, fetal brain MRI and cardiac sonography, which showed ventricular septal defect, were performed...
2016: BMJ Case Reports
Hong Ju Shin, Seunghwan Song, Han Ki Park, Young Hwan Park
BACKGROUND: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. METHODS: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. RESULTS: Twelve children, median age 6...
June 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Danton Char, Chandra Ramamoorthy, Lisa Wise-Faberowski
As physicians and caregivers of children with congenital heart disease, we are aware of the increasing need for procedures requiring anesthesia. While these procedures may be ideal for medical and cardiac surgical management, the risks and benefits must be assessed carefully. There are well known risks of cardiovascular and respiratory complications from anesthesia and sedation and a potentially under-appreciated risk of neurocognitive dysfunction. Both animal and human studies support the detrimental effects of repeated anesthetic exposure on the developing brain...
May 2016: Congenital Heart Disease
Ariane Marelli, Steven P Miller, Bradley Scott Marino, Angela L Jefferson, Jane W Newburger
The number of patients surviving with congenital heart disease (CHD) has soared over the last 3 decades. Adults constitute the fastest-growing segment of the CHD population, now outnumbering children. Research to date on the heart-brain intersection in this population has been focused largely on neurodevelopmental outcomes in childhood and adolescence. Mutations in genes that are highly expressed in heart and brain may cause cerebral dysgenesis. Together with altered cerebral perfusion in utero, these factors are associated with abnormalities of brain structure and brain immaturity in a significant portion of neonates with critical CHD even before they undergo cardiac surgery...
May 17, 2016: Circulation
Joseph Costa, Sowmyashree Sreekanth, Alex Kossar, Kashif Raza, Hilary Robbins, Lori Shah, Joshua R Sonett, Selim Arcasoy, Frank D'Ovidio
OBJECTIVES: End-stage lung disease continues to rise despite the lack of suitable lung donors, limiting the numbers of lung transplants performed each year. Expanded donor criteria, use of donation after cardiac death donors and the advent of ex vivo lung perfusion have resulted only in a slight increase in donor lung utilization. Organ donors with prior cardiac surgery (DPCS) present risks and technical challenges; however, they may be a potential source of suitable lung allografts with an experienced procurement surgeon...
May 4, 2016: European Journal of Cardio-thoracic Surgery
Gregory S Matte, Kevin R Connor, Hua Liu, James A DiNardo, David Faraoni, Frank Pigula
Gaseous microemboli (GME) are known to be delivered to the arterial circulation of patients during cardiopulmonary bypass (CPB). An increased number of GME delivered during adult CPB has been associated with brain injury and postoperative cognitive dysfunction. The GME load in children exposed to CPB and its consequences are not well characterized. We sought to establish a baseline of arterial limb emboli counts during the conduct of CPB for our population of patients requiring surgery for congenital heart disease...
March 2016: Journal of Extra-corporeal Technology
Amanda Hauck, Ruixin Guo, D Dunbar Ivy, Adel Younoszai
AIMS: Tricuspid annular plane systolic excursion (TAPSE) is a measure of right ventricular (RV) longitudinal function that correlates with functional status and mortality in adults with pulmonary hypertension (PH). The diagnostic and predictive value of TAPSE in children with PH has not been fully examined. We aimed to define TAPSE across aetiologies of paediatric PH and assess the correlation between TAPSE and measures of disease severity. METHODS AND RESULTS: TAPSE measurements were obtained in 84 children and young adults undergoing treatment for PH and 315 healthy children to establish z-scores at moderate altitude for comparison...
April 20, 2016: European Heart Journal Cardiovascular Imaging
M Brossard-Racine, A du Plessis, G Vezina, R Robertson, M Donofrio, W Tworetzky, C Limperopoulos
BACKGROUND AND PURPOSE: Brain injury in neonates with congenital heart disease is an important predictor of adverse neurodevelopmental outcome. Impaired brain development in congenital heart disease may have a prenatal origin, but the sensitivity and specificity of fetal brain MR imaging for predicting neonatal brain lesions are currently unknown. We sought to determine the value of conventional fetal MR imaging for predicting abnormal findings on neonatal preoperative MR imaging in neonates with complex congenital heart disease...
July 2016: AJNR. American Journal of Neuroradiology
Hirofumi Saiki, Masaya Sugimoto, Seiko Kuwata, Clara Kurishima, Yoichi Iwamoto, Hirotaka Ishido, Satoshi Masutani, Hideaki Senzaki
BACKGROUND: The mechanisms that regulate cerebral flow in patients after surgery for congenital heart diseases (CHDs) remain poorly understood. We tested our hypothesis that postoperative patients with CHD have disease- or hemodynamic-specific compensatory mechanisms for maintaining cerebral perfusion. METHODS: A total of 89 children with specific hemodynamics including Glenn (n = 14), Fontan (n = 19), repaired tetralogy of Fallot (n = 24), and control patients (n = 32) were enrolled...
February 2016: American Heart Journal
Laurie Seltzer, Michael F Swartz, Jennifer Kwon, James Burchfiel, Jill M Cholette, Hongyue Wang, Dawn Sweeney, Heather R Adams, Cecilia Meagher, Ron Angona, Ronnie Guillet, George M Alfieris
OBJECTIVES: Neonates with congenital heart disease are at risk for impaired neurodevelopment after cardiac surgery. We hypothesized that intraoperative EEG activity may provide insight into future neurodevelopmental outcomes. METHODS: Neonates requiring surgery had continuous intraoperative EEG and hemodynamic monitoring. The level of EEG suppression was classified as either: slow and continuous; moderate burst suppression; severe burst suppression; or isoelectric (no brain activity for >3 minutes)...
April 2016: Journal of Thoracic and Cardiovascular Surgery
Maryam Mirzaei, Samaneh Mirzaei, Elham Sepahvand, Afifeh Rahmanian Koshkaki, Marzieh Kargar Jahromi
INTRODUCTION: Today, with progress in the field of congenital heart surgery, different complicated actions are done in children. These actions may be associated with several complications, especially open heart surgery in which the cardiopulmonary bypass (CPB) is used. Serious complications can be caused high morbidity and mortality rates. Present study has been performed to determine the incidence of morbidity and mortality in cardiac surgery in children. METHOD: In a cross-sectional retrospective, records of 203 patients undergoing surgery for congenital heart disease in Dena hospital during 2013-2015 were reviewed for incidence of complications...
2016: Global Journal of Health Science
Yaser S M Alhamshari, Chitra Punjabi, Gregg S Pressman, Anita Govil
We present a case of 77-year-old immunocompetent patient who initially presented with vertigo, nausea and vomiting, with symptoms later progressing to headaches and increased lethargy. Brain MRI revealed ring-enhancing lesions typical of abscesses in the right cerebellum. Transoesophageal echocardiogram (TEE) was performed to look for the source of his abscesses, and uncovered a sinus venosus type atrial septal defect. Cardiac CT was carried out; the patient was found to have a sinus venosus atrial septal defect with partial anomalous pulmonary venous return...
2015: BMJ Case Reports
Alessandro Varrica, Angela Satriano, Alessandro Frigiola, Alessandro Giamberti, Guido Tettamanti, Luigi Anastasia, Erika Conforti, Antonio D W Gavilanes, Luc J Zimmermann, Hans J S Vles, Giovanni Li Volti, Diego Gazzolo
BACKGROUND: S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD) newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB), has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. METHODS: We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN) measurement were drawn at five perioperative time-points...
2015: BioMed Research International
Vinay Marulasiddappa, B S Raghavavendra
Children with uncorrected cyanotic congenital heart diseases can present for non cardiac surgeries. They pose several challenges to the Anaesthesiologist, especially when they are posted for emergency surgery, due to the complex haemodynamic changes secondary to the heart disease. Pentalogy of Fallot (POF) is a rare form of congenital heart disease characterized by the association of Tetralogy of Fallot (TOF) with an atrial septal defect (ASD). TOF is the leading cause of intracardiac right to left shunt and is the commonest type of cyanotic congenital heart disease to cause a brain abscess...
July 2015: Journal of Clinical and Diagnostic Research: JCDR
Usha D Nagaraj, Iordanis E Evangelou, Mary T Donofrio, L Gilbert Vezina, Robert McCarter, Adre J du Plessis, Catherine Limperopoulos
OBJECTIVE: To compare global and regional cerebral perfusion in newborns with congenital heart disease (CHD) and healthy controls using arterial spin labeling (ASL) magnetic resonance imaging (MRI) prior to open heart surgery. STUDY DESIGN: We performed brain MRIs in 101 newborns (58 controls, 43 CHD) using 3-dimensional fast spin echo pseudo-continuous ASL. Cerebral blood flow (CBF) ASL images were linearly coregistered to T2-weighted images for anatomic delineation and selection of regions-of-interest...
November 2015: Journal of Pediatrics
Michael Volodarsky, Hava Lichtig, Tom Leibson, Yair Sadaka, Rotem Kadir, Yonatan Perez, Keren Liani-Leibson, Libe Gradstein, Ruthy Shaco-Levy, Zamir Shorer, Dale Frank, Ohad S Birk
Siblings of non-consanguineous Jewish-Ethiopian ancestry presented with congenital axial hypotonia, weakness of the abducens nerve, psychomotor developmental delay with brain ventriculomegaly, variable thinning of corpus callosum and cardiac septal defects. Homozygosity mapping identified a single disease-associated locus of 3.5 Mb on chromosome 3. Studies of a Bedouin consanguineous kindred affected with a similar recessive phenotype identified a single disease-associated 18 Mb homozygosity locus encompassing the entire 3...
November 15, 2015: Human Molecular Genetics
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