The Congenital Heart Disease Brain: Prenatal Considerations for Perioperative Neurocritical Care

Pediatr Neurol. 2020 Jul:108:23-30. doi: 10.1016/j.pediatrneurol.2020.01.002. Epub 2020 Jan 22.

Abstract

Altered brain development has been highlighted as an important contributor to adverse neurodevelopmental outcomes in children with congenital heart disease. Abnormalities begin prenatally and include micro- and macrostructural disturbances that lead to an altered trajectory of brain growth throughout gestation. Recent progress in fetal imaging has improved understanding of the neurobiological mechanisms and risk factors for impaired fetal brain development. The impact of the prenatal environment on postnatal neurological care has also gained increased focus. This review summarizes current data on the timing and pattern of altered prenatal brain development in congenital heart disease, the potential mechanisms of these abnormalities, and the association with perioperative neurological complications.

Keywords: Brain; Brain development; Brain injury; Congenital heart disease; Fetal; Prenatal.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Brain* / abnormalities
  • Brain* / diagnostic imaging
  • Brain* / growth & development
  • Fetal Diseases* / diagnosis
  • Fetal Diseases* / therapy
  • Heart Defects, Congenital* / surgery
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases* / surgery
  • Intensive Care, Neonatal*
  • Perioperative Care*
  • Prenatal Diagnosis*