255 Preoperative Cranial Ultrasounds Findings in Infants with Congenital Heart Disease

Abstract

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 abnormalities in neonates with CHD and to examine the relationship between cerebral abnormalities and the type of CHD.

Methods. Retrospective study. Inclusion-criteria: 1) Neonates with CHD admitted to the NICU over a 3-year period, 2) Gestational age >35 weeks, 3) Documented preoperative cranial ultrasound available. Exclusion-criteria: 1) Small For Gestational Age, 2) Other congenital anomalies and/or chromosomal abnormalities, 3) Congenital TORCH infection. Cranial ultrasounds (CUS) were reviewed without knowledge of the cardiac defect. CHD were categorized.

Results: Fifty-one of 109 neonates with CHD met the inclusion criteria. Twenty-one patients (41%) had abnormalities on CUS. Thirteen of these (25%) had widened ventricular and/or subarachnoid spaces, 3 (6%) lenticulostriate vasculopathy, 1 (2%) calcification in the basal nuclei, and 4 (8%) neonates had acute ischemic changes. Cerebral abnormalities were found more frequently in patients with coarctation or hypoplastic left heart syndrome (HLHS) than transposition of the great arteries (TGA) (63% versus 14%).

Conclusions: There is a high incidence of preoperative cerebral ultrasound abnormalities in neonates with CHD.

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