• Paediatric anaesthesia · Jul 2011

    Review

    Should what we know about neurobehavioral development, complex congenital heart disease, and brain maturation affect the timing of corrective cardiac surgery?

    • James A DiNardo.
    • Children's Hospital Boston, Department of Anesthesiology, Boston, MA 02115, USA. james.dinardo@childrens.harvard.edu
    • Paediatr Anaesth. 2011 Jul 1;21(7):781-6.

    AbstractDespite remarkable improvements in perioperative care, adverse neurobehavioral outcomes following neonatal and infant cardiac surgery are commonplace and are associated with substantial morbidity. It is becoming increasingly clear that complex congenital heart disease is associated with both abnormalities in neuroanatomic development and a delay in fetal brain maturation. Substantial cerebral ischemic/hypoxic injury has been detected in neonates with complex congenital heart disease both prior to and following corrective cardiac surgery. The brain of the neonate with complex congenital heart disease appears to be uniquely vulnerable to the types of ischemic/hypoxic injury associated with perioperative care. It remains to be determined whether delaying surgical correction to allow for brain maturation will be associated with improvements in neurobehavioral outcomes.© 2010 Blackwell Publishing Ltd.

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