Can preoperative cranial ultrasound predict early neurodevelopmental outcome in infants with congenital heart disease?

Abstract

To determine the role of preoperative cranial ultrasound (cUS) in predicting neurodevelopmental outcome in infants undergoing bypass surgery for congenital heart disease (CHD). Prospective cohort study on 77 infants (44 males, 33 females) operated before 3months of age (median age at surgery 10d [range 3-88d]) who received at least one preoperative cUS. Outcome at 1year was assessed with a standardized neurological examination and the Bayley Scales of Infant Development II (mental developmental index [MDI]; psychomotor developmental index [PDI]). Abnormalities on cUS were detected in 22 (29%) infants and consisted of diffuse brain oedema (n=12, 16%), periventricular white matter injury (n=5, 6%), ventricular dilatation (n=3, 4%), and intraventricular haemorrhage (IVH) (n=2, 3%). Infants undergoing balloon-atrial septostomy (BAS) had a higher rate of subsequent brain oedema than those without BAS (p=0.006). cUS abnormalities were not related to neurodevelopmental outcome. Preoperative cUS findings in infants undergoing bypass surgery for CHD occur rather frequently, consisting of mild lesions such as brain oedema or white matter changes. These findings, however, do not correlate with early neurodevelopmental outcome.