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Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration

Authors :
Bonthrone, Alexandra F; https://orcid.org/0000-0001-5487-5564
Stegeman, Raymond; https://orcid.org/0000-0001-9874-5470
Feldmann, Maria; https://orcid.org/0000-0002-6616-3510
Claessens, Nathalie H P; https://orcid.org/0000-0002-4221-2779
Nijman, Maaike; https://orcid.org/0000-0001-9665-0291
Jansen, Nicolaas J G; https://orcid.org/0000-0003-3106-3824
Nijman, Joppe; https://orcid.org/0000-0002-9843-0740
Groenendaal, Floris
de Vries, Linda S; https://orcid.org/0000-0002-7282-8304
Benders, Manon J N L; https://orcid.org/0000-0001-5491-9168
Haas, Felix
Bekker, Mirielle N; https://orcid.org/0000-0002-7372-4291
Logeswaran, Thushiha
Reich, Bettina
Kottke, Raimund; https://orcid.org/0000-0003-0166-2770
Hagmann, Cornelia
Latal, Beatrice; https://orcid.org/0000-0003-1309-4790
Dave, Hitendu
Simpson, John; https://orcid.org/0000-0002-9773-7441
Pushparajah, Kuberan; https://orcid.org/0000-0003-1541-1155
Austin, Conal
Kelly, Christopher J; https://orcid.org/0000-0002-1246-844X
Arulkumaran, Sophie; https://orcid.org/0000-0002-4510-1767
Rutherford, Mary A
Counsell, Serena J; https://orcid.org/0000-0002-8033-5673
Knirsch, Walter; https://orcid.org/0000-0002-8741-3929
Breur, Johannes M P J; https://orcid.org/0000-0001-8009-8869
Bonthrone, Alexandra F; https://orcid.org/0000-0001-5487-5564
Stegeman, Raymond; https://orcid.org/0000-0001-9874-5470
Feldmann, Maria; https://orcid.org/0000-0002-6616-3510
Claessens, Nathalie H P; https://orcid.org/0000-0002-4221-2779
Nijman, Maaike; https://orcid.org/0000-0001-9665-0291
Jansen, Nicolaas J G; https://orcid.org/0000-0003-3106-3824
Nijman, Joppe; https://orcid.org/0000-0002-9843-0740
Groenendaal, Floris
de Vries, Linda S; https://orcid.org/0000-0002-7282-8304
Benders, Manon J N L; https://orcid.org/0000-0001-5491-9168
Haas, Felix
Bekker, Mirielle N; https://orcid.org/0000-0002-7372-4291
Logeswaran, Thushiha
Reich, Bettina
Kottke, Raimund; https://orcid.org/0000-0003-0166-2770
Hagmann, Cornelia
Latal, Beatrice; https://orcid.org/0000-0003-1309-4790
Dave, Hitendu
Simpson, John; https://orcid.org/0000-0002-9773-7441
Pushparajah, Kuberan; https://orcid.org/0000-0003-1541-1155
Austin, Conal
Kelly, Christopher J; https://orcid.org/0000-0002-1246-844X
Arulkumaran, Sophie; https://orcid.org/0000-0002-4510-1767
Rutherford, Mary A
Counsell, Serena J; https://orcid.org/0000-0002-8033-5673
Knirsch, Walter; https://orcid.org/0000-0002-8741-3929
Breur, Johannes M P J; https://orcid.org/0000-0001-8009-8869
Source :
Bonthrone, Alexandra F; Stegeman, Raymond; Feldmann, Maria; Claessens, Nathalie H P; Nijman, Maaike; Jansen, Nicolaas J G; Nijman, Joppe; Groenendaal, Floris; de Vries, Linda S; Benders, Manon J N L; Haas, Felix; Bekker, Mirielle N; Logeswaran, Thushiha; Reich, Bettina; Kottke, Raimund; Hagmann, Cornelia; Latal, Beatrice; Dave, Hitendu; Simpson, John; Pushparajah, Kuberan; Austin, Conal; Kelly, Christopher J; Arulkumaran, Sophie; Rutherford, Mary A; Counsell, Serena J; Knirsch, Walter; Breur, Johannes M P J (2022). Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration. Stroke, 53(12):3652-3661.
Publication Year :
2022

Abstract

Background: Infants with congenital heart disease are at risk of brain injury and impaired neurodevelopment. The aim was to investigate risk factors for perioperative brain lesions in infants with congenital heart disease. Methods: Infants with transposition of the great arteries, single ventricle physiology, and left ventricular outflow tract and/or aortic arch obstruction undergoing cardiac surgery <6 weeks after birth from 3 European cohorts (Utrecht, Zurich, and London) were combined. Brain lesions were scored on preoperative (transposition of the great arteries N=104; single ventricle physiology N=35; and left ventricular outflow tract and/or aortic arch obstruction N=41) and postoperative (transposition of the great arteries N=88; single ventricle physiology N=28; and left ventricular outflow tract and/or aortic arch obstruction N=30) magnetic resonance imaging for risk factor analysis of arterial ischemic stroke, cerebral sinus venous thrombosis, and white matter injury. Results: Preoperatively, induced vaginal delivery (odds ratio [OR], 2.23 [95% CI, 1.06-4.70]) was associated with white matter injury and balloon atrial septostomy increased the risk of white matter injury (OR, 2.51 [95% CI, 1.23-5.20]) and arterial ischemic stroke (OR, 4.49 [95% CI, 1.20-21.49]). Postoperatively, younger postnatal age at surgery (OR, 1.18 [95% CI, 1.05-1.33]) and selective cerebral perfusion, particularly at ≤20 °C (OR, 13.46 [95% CI, 3.58-67.10]), were associated with new arterial ischemic stroke. Single ventricle physiology was associated with new white matter injury (OR, 2.88 [95% CI, 1.20-6.95]) and transposition of the great arteries with new cerebral sinus venous thrombosis (OR, 13.47 [95% CI, 2.28-95.66]). Delayed sternal closure (OR, 3.47 [95% CI, 1.08-13.06]) and lower intraoperative temperatures (OR, 1.22 [95% CI, 1.07-1.36]) also increased the risk of new cerebral sinus venous thrombosis. Conclusions: Delivery planning and surgery timing may be modifiable risk fac

Details

Database :
OAIster
Journal :
Bonthrone, Alexandra F; Stegeman, Raymond; Feldmann, Maria; Claessens, Nathalie H P; Nijman, Maaike; Jansen, Nicolaas J G; Nijman, Joppe; Groenendaal, Floris; de Vries, Linda S; Benders, Manon J N L; Haas, Felix; Bekker, Mirielle N; Logeswaran, Thushiha; Reich, Bettina; Kottke, Raimund; Hagmann, Cornelia; Latal, Beatrice; Dave, Hitendu; Simpson, John; Pushparajah, Kuberan; Austin, Conal; Kelly, Christopher J; Arulkumaran, Sophie; Rutherford, Mary A; Counsell, Serena J; Knirsch, Walter; Breur, Johannes M P J (2022). Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration. Stroke, 53(12):3652-3661.
Notes :
application/pdf, info:doi/10.5167/uzh-222230, English, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1443046715
Document Type :
Electronic Resource