Brain injuries drop 20% for babies with heart defects

Date:
February 1, 2023
Source:
University of California - San Francisco
Summary:
Recent advances in newborn heart surgery have greatly reduced brain
injuries in infants with congenital heart disease, according to
a 20-year study.


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FULL STORY ========================================================================== Recent advances in newborn heart surgery have greatly reduced brain
injuries in infants with congenital heart disease, according to a 20-year
study by scientists at UCSF Benioff Children's Hospitals and British
Columbia Children's Hospital (BCCH).


==========================================================================
The study, begun in 2001 and published this month in the Journal of the American College of Cardiology, analyzed brain imaging data from 270
full-term UCSF and BCCH newborns with congenital heart disease (CHD) for changes in brain injuries before and after newborn cardiac surgery. The scientists confirmed that recent advances in surgical and clinical care
that maintain a higher postoperative blood pressure resulted in reducing
brain injuries and better chances of patient survival.

"We were surprised to find that advances in care over the past 7 years
resulted in a clear decline in brain injury linked to increasing the
patient's blood pressure following surgery," said Shabnam Peyvandi,
MD, lead author and pediatric cardiologist for UCSF Benioff Children's Hospitals. "With advances in cardiac therapy and outcomes, our focus now
is helping these children thrive." CHD, which refers to one or more abnormalities of an infant's heart, impacts 40,000 newborns a year in
the U.S. It is the most common newborn birth defect.

About 1 in 4 of these infants have critical CHD and require surgery in the first month to first year of life. Heart abnormalities include improperly functioning heart valves, a hole in the muscular wall separating the
heart chambers, and malformations in the heart's blood vessels, which
can result in altered patterns of blood flow. These anomalies reduce
the flow of oxygen and nutrients to the brain and organs before birth,
and can contribute to lifelong neurological and developmental disorders.

New Approaches to Monitor Brain Health To monitor infant brain health
for the study, UCSF and BCCH scientists used advanced magnetic resonance
(MRI) brain imaging before and after heart surgery and consistently
as the patient aged. The data was divided into four sequential stages,
each containing five consecutive years of data. In the fourth and final
stage, which ran from 2016 to 2021, infants were maintained at higher
post- surgical blood pressures than in previous groups. This resulted
in an almost 20% reduction in post-surgical brain injuries compared to
the first group in 2001.

During the course of this study, Peyvandi and the UCSF Benioff
Children's Hospitals Pediatric Heart Center published multiple articles investigating brain development and white matter injuries -- including
a link between moderate-severe white matter injuries that led to delays
in childhood motor function -- that opened the door to improving long
term developmental outcomes by decreasing early brain injuries.

"Taken together, these findings underscore the importance of tracking
brain injury and implementing changes to reduce occurrences that
will improve outcomes," said Patrick McQuillen, MD, senior author and
professor of Pediatrics, UCSF Benioff Children's Hospitals. "Based on
this research and others, several leading heart centers have incorporated
brain imaging into routine clinical practice." Work from this group has directly informed the creation of novel clinical programs to monitor and protect the brain in fetuses, newborns and children with CHD, including
the Healthy Hearts & Minds Program and the Neonatal Cardiovascular
Center of Excellence Growth and Neurodevelopment (GRAND) program that incorporates developmental care on the inpatient setting for newborns
with critical CHD.

Other UCSF authors include Duan Xu, PHD, A. James Barkovich, MD, Dawn
Gano, MD, MAS, V. Mohan Reddy, MD
* RELATED_TOPICS
o Health_&_Medicine
# Infant's_Health # Heart_Disease # Birth_Defects #
Brain_Tumor # Medical_Devices # Diseases_and_Conditions #
Stroke_Prevention # Accident_and_Trauma
* RELATED_TERMS
o Ischaemic_heart_disease o Coronary_heart_disease o
Artificial_heart o Heart_rate o CPR o Heart_failure o Infant
o Rheumatic_fever

========================================================================== Story Source: Materials provided by
University_of_California_-_San_Francisco. Original written by Lorna
Fernandes. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Shabnam Peyvandi, Duan Xu, A. James Barkovich, Dawn Gano, Vann
Chau, V.

Mohan Reddy, Thiviya Selvanathan, Ting Guo, J. William Gaynor,
Mike Seed, Steven P. Miller, Patrick McQuillen. Declining
Incidence of Postoperative Neonatal Brain Injury in Congenital
Heart Disease. Journal of the American College of Cardiology,
2023; 81 (3): 253 DOI: 10.1016/ j.jacc.2022.10.029 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/02/230201134231.htm

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