51 - Long-Term Neurologic Outcomes in Children With Congenital Heart Disease

Abstract

Congenital heart disease (CHD) is one of the most common birth defects. With advancements in surgical techniques and perioperative care, survival has improved for complex CHD with an increase in morbidities such as neurodevelopmental impairments. Evidence suggests that children, adolescents, and adults with complex forms of CHD can exhibit difficulties in multiple domains, including visual-spatial skills, memory, executive function, speech and language and gross and fine motor function. These difficulties have the potential to have a significant impact on the ability to gain independence and contribute to society. Much of the literature suggests that patient-specific risk factors beginning in utero play essential roles in determining ultimate neurodevelopmental outcomes. In this chapter, we review mechanisms influencing neurologic outcomes in CHD. In particular, we discuss the physiologic effects of CHD on the developing brain beginning in utero, the utility of advanced imaging techniques such as brain MRI to understand brain development, and the timing, appearance, and mechanisms of acquired brain injuries. We also review current knowledge on neurodevelopmental outcomes in complex CHD in the short and long term, as well as future areas of research as the field of congenital cardiology evolves.