Newborns with heart defect have low blood flow in brain before surgery

As survival rates have steadily improved for children with heart defects, physicians have focused more attention on improving quality-of-life factors such as neurological and cognitive abilities. A new study shows that newborns with congenital heart disease often have abnormally low blood flow in their brains before they undergo surgery.

Researchers from The Children's Hospital of Philadelphia led the study, published in the December issue of The Journal of Thoracic and Cardiovascular Surgery.

One of every 100 children is born with a heart defect--one-third of which are severe enough to require surgery during the newborn period. Many of those high-risk children are identified as having neurological and cognitive problems during the months and years that follow. While some of these problems may be related to the complexity of the surgery, evidence is mounting that abnormal neurological conditions play a role even before surgery.

The current study, which used a novel magnetic resonance imaging (MRI) technique developed by members of the investigative team, was the first to measure the infants' cerebral blood flow before surgery. The reduced blood flow was associated with abnormal features in the newborn brain, according to pediatric neurologist Daniel J. Licht, M.D., who led the multidisciplinary research team at Children's Hospital.

"Some of the neurodevelopmental problems that these children experience may be attributable to necessary surgical practices such as heart-lung bypass," said Dr. Licht. "However, many infants with heart defects have neurological abnormalities before surgery."

The research team at The Children's Hospital of Philadelphia studied 25 newborns born at term with congenital heart defects. They found cerebral blood flow to be significantly lower than in healthy newborns, sometimes drastically reduced. The low blood flow was also associated with a condition called periventricular leukomalacia (PVL),

Contact: John Ascenzi
Children's Hospital of Philadelphia

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