Akademik Veri Yönetim Sistemi
Turkiye Klinikleri Cardiovascular Sciences, cilt.24, sa.1, ss.60-67, 2012 (Scopus)
Neurodevelopmental impairment is common in newborns and infants undergoing corrective or palliative congenital heart surgery. The etiologies of neurodevelopmental morbidity in these children are multifactorial and include prenatal, preoperative, intraoperative, and postoperative factors. However, over the past 30 years, total correction of previously inoperable congenital cardiac defects had been performed with increasing frequency in children. Some children have more risk of neurodevelopmental problems, either because of their cardiac or cerebrovascular anatomy or because of genetic predisposition (prothrombotic disorders). The other factors include many variables specific to the individual patient, including gender, race, socioeconomic status, and in utero central nervous system development. The incidence may vary with the surgery (Fontan operation)and the cardiopulmonary bypass (CPB) technique necessary to achieve an adequate repair(deep hypothermic circulatory arrest and hemodilution). While most of the children undergoing cardiac surgery survive without any deficit, there is an increasing concern about neurological sequel seen in some patients. New techniques such as low-flow CPB, pulsatile CPB, pH-stat acid-base management and a cold reperfusion, are being explored to ensure better cerebral protection. The understanding of the causes of central nervous system complications and applying neuroprotective management strategies to preserve neurologic function in children with congenital heart disease is crucially important. Copyright © 2012 by Türkiye Klinikleri.