Congenital heart defects affects long-term development

Approximately one percent of all newborns in Switzerland are diagnosed with a congenital heart defect, roughly half of them require open heart surgery. Most children, including those with the most severe heart defects, survive because of the significant advancements in surgical techniques. Therefore, the current research focuses less on survival than on long-term consequences and quality of life of these children.   

Aside from cardiac complications, developmental problems may emerge after a complex cardiac surgical procedure. Children may suffer from motor, language or learning difficulties. The etiology of these problems is multifactorial and the association with the surgical procedure, which affects systemic circulation and can impair , is not clear. For the first time, researchers from the Children's Hospital Zurich demonstrate that morphological changes of the brain can be detected many years after open- and can have a long-term impact on brain development. However, the researchers also discovered that brain changes may already exist before the cardiac surgery. This indicates that the neurological risks associated with the itself are smaller than previously believed.  

Smaller brain volume with severe heart defects

Under the supervision of the pediatrician Bea Latal, the postdoctoral student Michael von Rhein studied a group of 39 14-year-old congenital heart patients who had undergone during early childhood in the late 1990s. The adolescents underwent extensive testing of cognitive and motor skills and the as well as specific brain regions, were measured using cerebral magnetic resonance imaging. "It became evident that these former cardiac patients had around 10 percent less brain volume than healthy young people," explains von Rhein. Patients with severe were most affected by this volume loss. 

The researchers were also able to demonstrate that adolescents with congenital were more likely to exhibit learning and motor difficulties than healthy control people.

These difficulties were more pronounced in those with smaller brain volumes. Despite these difficulties, however, most of adolescent patients were able to attend regular school and their quality of life was not impaired.    

In another, recently published study, the developmental pediatrician Bea Latal and pediatric cardiologist Walter Knirsch from the Children's Hospital Zurich revealed that the development of children with a congenital heart defect can be delayed prior to surgery and that mild cerebral changes can occur- long before the life-saving heart surgery is performed. "Evidently, the changes in the brain that are detectable at such an early time persist and may influence further development into adolescence," concludes Latal from the results of the study.  

More information: M. von Rhein, A. Buchmann, R. Huber, P. Klaver, C. Hagmann, W. Knirsch, B. Latal. Smaller brain volume correlates with neurodevelopmental function in adolescents after bypass repair for congenital heart disease. Brain. November 25, 2013, DOI: 10.1093/brain/awt322

S. Bertholdt, B. Latal, R. Liamlahia, I. Scheer, R. Prêtre, R. Goetti, H. Dave, V. Bernet, A. Schmitz, M. von Rhein, W. Knirsch, and the Research Group Heart and Brain. Cerebral lesions on MRI correlate withpreoperative neurological status in neonates undergoing cardiopulmonary bypass surgery. European Journal of Cardio-Thoracic Surgery, 2013, DOI: 10.1093/ejcts/ezt422

C. Schaefer, M. von Rhein, W. Knirsch, R. Huber, G. Natalucci, J. Caflisch, M. Landolt, B. Latal B. Neurodevelopmental outcome, behavior and quality of life in adolescents with congenital heart disease. DevMed Child Neuro. 2013, DOI: 10.1111/dmcn.12242

add to favorites email to friend print save as pdf

Related Stories

Environmental toxins linked to heart defects

Nov 17, 2013

Children's congenital heart defects may be associated with their mothers' exposure to specific mixtures of environmental toxins during pregnancy, according to research presented at the American Heart Association's Scientific ...

No drop in IQ seen after bypass for child heart surgery

Nov 10, 2008

The use of cardiopulmonary bypass does not cause short-term neurological problems in children and teenagers after surgery for less complex heart defects, according to pediatric researchers. The new finding contrasts favorably ...

Recommended for you

Gene variant raises risk for aortic tear and rupture

Apr 17, 2014

Researchers from Yale School of Medicine and Celera Diagnostics have confirmed the significance of a genetic variant that substantially increases the risk of a frequently fatal thoracic aortic dissection or full rupture. ...

Considerable variation in CT use in ischemic stroke

Apr 17, 2014

(HealthDay)—For patients with ischemic stroke there is considerable variation in the rates of high-intensity computed tomography (CT) use, according to a study published online April 8 in Circulation: Ca ...

Beating the clock for ischemic stroke sufferers

Apr 17, 2014

A ground-breaking computer technology raises hope for people struck by ischemic stroke, which is a very common kind of stroke accounting for over 80 per cent of overall stroke cases. Developed by research experts at The Hong ...

User comments