The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Brain maturation is delayed in infants with complex congenital heart defects
Open accessAbstract
Objective Small head circumferences and white matter injury in the form of periventricular leukomalacia have been observed in populations of infants with severe forms of congenital heart defects. This study tests the hypothesis that congenital heart defects delay in utero structural brain development.Methods Full-term infants with hypoplastic left heart syndrome or transposition of the great arteries were prospectively evaluated with preoperative brain magnetic resonance imaging. Patients with independent risk factors for abnormal brain development (shock, end-organ injury, or intrauterine growth retardation) were excluded. Outcome measures included head circumferences and the total maturation score on magnetic resonance imaging. Total maturation score is a previously validated semiquantitative anatomic scoring system used to assess whole brain maturity. The total maturation score evaluates 4 parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue.Results The study cohort included 29 neonates with hypoplastic left heart syndrome and 13 neonates with transposition of the great arteries at a mean gestational age of 38.9 +/- 1.1 weeks. Mean head circumference was 1 standard deviation below normal. The mean total maturation score for the cohort was 10.15 +/- 0.94, significantly lower than reported normative data in infants without congenital heart defects, corresponding to a delay of 1 month in structural brain development.Conclusion Before surgery, term infants with hypoplastic left heart syndrome and transposition of the great arteries have brains that are smaller and structurally less mature than expected. This delay in brain development may foster susceptibility to periventricular leukomalacia in the preoperative, intraoperative, and postoperative periods.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Reports from a number of investigators have documented a high prevalence of anatomic and functional neurologic abnormalities prior to surgery in newborns with CHD [9-17], and an association of such abnormalities with childhood developmental status [11,13,18,19].”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [17]
In the citing paper
“However, there is increasing evidence that adverse neurodevelopmental outcomes in children with complex CHD are due not only perioperative insult, but to inborn factors as well.”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [17]
In the citing paper
“Studies have documented a high prevalence of peri-operative brain injury and delayed brain development in neonates with CHD (7–10).”
From Neonatal Brain Injury and Timing of Neurodevelopmental Assessment in Patients With Congenital Heart Disease (2018) · cites this paper as [9]
In the citing paper
“Similar findings have been observed in human newborns with congenital heart disease (CHD) at autopsy and on brain-imaging studies.[27][28][29][30]”
From Associations Between Age at Arterial Switch Operation, Brain Growth, and Development in Infants With Transposition of the Great Arteries (2019) · cites this paper as [29]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
1 retracted
Dent, C., Spaeth, J., Jones, B., Schwartz, S. M., Glauser, T., Hallinan, B., Pearl, J., Khoury, P., & Kurth, C. (2005) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2005.07.051 · Cited by 194
RetractedVolpe, J. J. (1981) · PubMed · Cited by 2,859
Back, S. A., Luo, N. L., Borenstein, N. S., Levine, J. M., Volpe, J. J., & Kinney, H. C. (2001) · Journal of Neuroscience · doi:10.1523/jneurosci.21-04-01302.2001 · Cited by 936
Abnormal brain development in newborns with congenital heart disease
Miller, S. P., McQuillen, P. S., Hamrick, S., Xu, D., Glidden, D. V., Charlton, N., Karl, T., Azakie, A., Ferriero, D. M., Barkovich, A. J., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa067393 · Cited by 860
Bellinger, D. C., Wypij, D., duPlessis, A. J., Rappaport, L. A., Jonas, R. A., Wernovsky, G., & Newburger, J. W. (2003) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(03)00711-6 · Cited by 681
Self-citationAn MRI Study of Neurological Injury Before and After Congenital Heart Surgery
Mahle, W. T., Tavani, F., Zimmerman, R. A., Nicolson, S. C., Galli, K. K., Gaynor, J. W., Clancy, R. R., Montenegro, L. M., Spray, T. L., Chiavacci, R. M., et al. (2002) · Circulation · doi:10.1161/01.cir.0000032908.33237.b1 · Cited by 541
Self-citationTemporal and anatomic risk profile of brain injury with neonatal repair of congenital heart defects
McQuillen, P. S., Barkovich, A. J., Hamrick, S. E. G., Perez, M., Ward, P., Glidden, D. V., Azakie, A., Karl, T., & Miller, S. P. (2007) · Stroke · doi:10.1161/01.str.0000247941.41234.90 · Cited by 379
Donofrio, M. T., Bremer, Y. A., Schieken, R. M., Gennings, C., Morton, L. D., Eidem, B. W., Cetta, F., Falkensammer, C. B., Huhta, J. C., & Kleinman, C. S. (2003) · Pediatric Cardiology · doi:10.1007/s00246-002-0404-0 · Cited by 364
Periventricular leukomalacia is common after neonatal cardiac surgery
Galli, K. K., Zimmerman, R. A., Jarvik, G. P., Wernovsky, G., Kuypers, M., Clancy, R. R., Montenegro, L. M., Mahle, W. T., Newman, M. F., Saunders, A. M., et al. (2004) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2003.09.053 · Cited by 352
Self-citationShillingford, A. J., Glanzman, M. M., Ittenbach, R. F., Clancy, R. R., Gaynor, J. W., & Wernovsky, G. (2008) · Pediatrics · doi:10.1542/peds.2007-1066 · Cited by 348
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Items 601–629 of 629
Neurodevelopment at 24 Months of Age of Children Born Preterm with Congenital Heart Disease
Robinet, A., Werner, O., Baruteau, A., Roux, B. G., Flamant, C., Rouger, V., Leduc, G., Joram, N., Chenouard, A., & Bourgoin, P. (2026) · Pediatric Cardiology · doi:10.1007/s00246-026-04248-6
Cardiopathie congénitale : morbi-mortalité, neurodéveloppement et qualité de vie
Derridj, N. (2022) · theses.fr (ABES) · doi:10.70675/bd2c0354z6200z4422za51fz522ca567b340
Cortical morphology and cognitive impairments in adolescents with complex congenital heart disease
Toyofuku, A., Ehrler, M., Kretschmar, O., Latal, B., & Tuura, R. (2026) · Brain Communications · doi:10.1093/braincomms/fcag124
Yi, J., Zeng, G., Li, L., Liu, L., Zhang, D., Wang, H., Wang, Z., Liu, K., & Wu, J. (2026) · JTCVS Open · doi:10.1016/j.xjon.2026.101807
Kebede, A. F. (2026) · Qeios · doi:10.32388/mmop02
Vakil, D. P., Ruzmetov, M. M., Ostrower, S. T., Dentel, J. N., Scholl, F. G., & Bibevski, S. (2026) · World Journal for Pediatric and Congenital Heart Surgery · doi:10.1177/21501351261432665
Önsel, İ. Ö., Kırat, B., Avşar, M. K., Benli, O., & Zeybek, C. (2026) · BMC Pediatrics · doi:10.1186/s12887-026-06863-x
Cerebral Protection and Chaos Theory: The Butterfly Effect on Display
Overman, D. M. (2026) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2026.05.006
Kebede, A. F. (2026) · Qeios · doi:10.32388/mmop02.2
Dagur, G., Ortinau, C. M., Chin, T. I., Morris, G., Kleinmahon, J. A., Gurvitz, M. Z., & Bora, S. (2026) · PEDIATRICS · doi:10.1542/peds.2025-071101
Jacobwitz, M., Kapse, K. J., Ngwa, J. S., Asis‐Cruz, J. D., Wu, Y., Govindan, R. B., McDermott, C., Donofrio, M. T., du Plessis, A., Limperopoulos, C., et al. (2026) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd13060236
Zepf, J., & Flake, A. W. (2026) · Seminars in Pediatric Surgery · doi:10.1016/j.sempedsurg.2026.151662
Neonatal Brain Network Integration Trajectories Predict Neurodevelopment in Congenital Heart DiseasePreprint
Harasymiw, L., Kuang, A. W., Xu, D., Scheffler, A., George, E., Peyvandi, S., & McQuillen, P. S. (2026) · medRxiv · doi:10.64898/2026.06.06.26355074
Predictors of Abnormal Transfontanelle Ultrasound Findings in Neonates with Congenital Heart Disease
Moraru, L., Mayaya, P.-C., Hanganu, E., Moraru, R., Bivoleanu, A. R., & Damian, S. I. (2026) · Journal of Cardiovascular Emergencies · doi:10.2478/jce-2026-0006
Kebede, A. F. (2026) · Qeios · doi:10.32388/mmop02.3
Brain volumes in congenital heart disease from childhood to adulthood: A pooled neuroimaging study
Toyofuku, A., Naef, N., Rousson, V., Ehrler, M., Wehrle, F. M., Schlosser, L., von Rhein, M., Liamlahi, R., Greutmann, M., Kretschmar, O., et al. (2026) · Neuroimage Reports · doi:10.1016/j.ynirp.2026.100379
Cerebral autoregulation in congenital heart disease
van de Bunt, A., Breur, J. M. P. J., & van der Heyden, M. A. G. (2026) · Progress in Pediatric Cardiology · doi:10.1016/j.ppedcard.2026.101961
Congenital Heart Disease and Neonatal Brain Injury
Mills, M., McArthur, E., Bhombal, S., Maher, K., & Hamrick, S. E. G. (2026) · Cambridge University Press eBooks · doi:10.1017/9781009418034.039
Rethinking cardiac neurodevelopment: a dimensional model of adversity in congenital heart disease
Cassidy, A. R. (2026) · Frontiers in Pediatrics · doi:10.3389/fped.2026.1888600
Marshall, M., Demianczyk, A. C., Rao, R., Wray, J., & Marino, B. S. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-11851-7.00082-3
Fetal MRI Reveals Altered Subplate Development in Congenital Heart DiseasePreprint
Gondová, A., Jeong, S., Stepovich, N., Tworetzky, W., Bradford, V. R., Sadhwani, A., Zhang, J., You, S., Grant, P. E., Im, K., et al. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.08.18.745587
Strategies to Improve Neurologic Outcomes in Neonatal Cardiac Surgery
Hsia, J., Herrup, E. A., Burnham, A., Hampton, L., Lynch, J. M., Massey, S. L., & Naim, M. Y. (2026) · Current Treatment Options in Pediatrics · doi:10.1007/s40746-026-00381-9
Early motor behavior reflects neurologic involvement in infants with congenital heart disease
Peyton, C., Boswell, L., Crean, A., Hahn, E., Hill, J., Mann, I., O'Connor, A., Stein, K., Vogel, C., & de Regnier, R.-A. O. (2026) · Early Human Development · doi:10.1016/j.earlhumdev.2026.106663
Kelleher, S. T., Patangia, D. V., Ross, R. P., James, A. T., Stanton, C., & McMahon, C. J. (2026) · Heart · doi:10.1136/heartjnl-2026-328544
Hou, S., Wang, J., Mao, B., Zhou, Y., & Wang, J. (2026) · Early Human Development · doi:10.1016/j.earlhumdev.2026.106693
Ye, Z., He, Y., Guo, J., Meng, J., 胥雨菲, Wang, Y., & Wang, B. (2026) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd13100529
Hesari, M., Farag, A. M., Peterson, D., Kingdon, T., Bagheri-Asl, M. M., Ganta, S., El-Sabrout, H. R., Ryan, J. R., Gordon, B., Justino, H., et al. (2026) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2026.105691
Neonatal brain network integration trajectories predict neurodevelopment in congenital heart disease
Harasymiw, L. A., Kuang, A. W., Xu, D., Scheffler, A., George, E., Peyvandi, S., & McQuillen, P. S. (2026) · Pediatric Research · doi:10.1038/s41390-026-05546-8
Anesthesia for Cardiac Surgery in Neonates
Miller‐Hance, W. C., Gottlieb, E. A., & Motta, P. (2014) · Springer eBooks · doi:10.1007/978-1-4419-6041-2_12
Metadata
- Authors
- Licht, D. J., Shera, D. M., Clancy, R. R., Wernovsky, G., Montenegro, L. M., Nicolson, S. C., Zimmerman, R. A., Spray, T. L., Gaynor, J. W., & Vossough, A.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Corresponding author
- Licht, Daniel J.
- ORCID
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 2009-03
- Volume
- 137
- Issue
- 3
- Pages
- 529-537
- ISSN
- 0022-5223 (ISSN-L)
- PMC
- PMC2701902
- OpenAlex
- W2105478587
- Cited by
- 629
- References
- 31
- Citations by year
- 2026: 34 · 2025: 30 · 2024: 30 · 2023: 47 · 2022: 40 · 2021: 41 · 2020: 42 · 2019: 49 · 2018: 39 · 2017: 42 · 2016: 49 · 2015: 33 · 2014: 32 · 2013: 30 · 2012: 36
- FWCI
- 20.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (K23NS052380)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Keywords
- congenital heart disease, brain maturation, hypoplastic left heart syndrome, transposition of the great arteries, head circumference, periventricular leukomalacia, white matter injury, germinal matrix, myelination, neonates
- MeSH terms
- Brain, Female, Fetal Growth Retardation, Heart Defects, Congenital, Humans, Infant, Newborn, Male, Prospective Studies, Time Factors, Transposition of Great Vessels, Hypoplastic Left Heart Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
