Current insights regarding neurological and developmental abnormalities in children and young adults with complex congenital cardiac disease
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Over a decade ago, I co-authored a review in Cardiology in the Young regarding neurological outcomes following surgery for congenital cardiac disease. 1 In that review, I placed much emphasis on the conduct of cardiopulmonary bypass, and its role in neurodevelopmental disabilities. Much has been learned in the intervening years regarding the multifactorial causes of abnormal school-age development, in particular, the role of prenatal, perioperative, socioeconomic, and genetic influences. In this update, I will highlight some of the recent advances in our understanding of the protean causes of neurological, behavioral, and developmental abnormalities in children and young adults with complex forms of congenital cardiac disease. In addition, I will summarize the current data on patients at particular high-risk for adverse neurodevelopmental outcomes, specifically those with a functionally univentricular heart who have had staged reconstruction with ultimate conversion to the Fontan circulation.
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Childhood cognitive functioning declines as congenital heart disease severity increases, and it also appears to depend on the length of the neonatal perioperative course.
“Childhood cognitive functioning decreases with increasing severity of CHD, 4 but also seems to be dependent on the length of neonatal perioperative course.16”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [4]
People who survive congenital heart disease continue to show functional deficits during early childhood and adolescence.
“However, survivors of CHD continue to show functional deficits in early childhood and adolescence.[2][3][4][5]”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [4]
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- Authors
- Wernovsky, G.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Corresponding author
- Wernovsky, Gil
- ORCID
- Wernovsky, Gil
- Venue
- Cardiology in the Young
- Publisher
- Cambridge University Press (CUP)
- Published
- 2006-01-10
- Volume
- 16
- Issue
- S1
- Pages
- 92-104
- ISSN
- 1047-9511 (ISSN-L)
- 1467-1107
- OpenAlex
- W2022607976
- Cited by
- 335
- References
- 92
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 12 · 2023: 18 · 2022: 24 · 2021: 11 · 2020: 24 · 2019: 22 · 2018: 17 · 2017: 25 · 2016: 20 · 2015: 19 · 2014: 12 · 2013: 15 · 2012: 14
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cardiology in the Young (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- complex congenital heart disease, neurodevelopmental outcomes, developmental disabilities, behavioral abnormalities, cardiopulmonary bypass, single ventricle, Fontan circulation, prenatal risk factors, genetic risk factors, socioeconomic factors, children and young adults
- MeSH terms
- Adult, Cerebrovascular Disorders, Child, Developmental Disabilities, Heart Defects, Congenital, Humans, Prognosis, Quality of Life
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