Division of Cardiology, Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA.
Curr Opin Pediatr. 2021 Oct 1;33(5):489-494. doi: 10.1097/MOP.0000000000001057.
To introduce the reader to the current understanding of the neurocognitive profile of congenital heart disease (CHD) survivors, the risk factors that may influence outcomes, and to the recommendations for cardiac neurodevelopmental care.
A growing body of literature has shown that survivors of CHD are at increased risk for neurodevelopmental impairments. Multiple elements influence each patient's risk, which likely begins in utero and extends to perioperative management, surgical considerations, and long-term clinical care. Additionally, sociodemographic factors may compound these risks. Serial developmental follow-up is recommended for children with critical CHD.
Though there are some clinical factors that increase risk, based on the high rate of developmental impairments for children with CHD, serial evaluations are recommended. Multidisciplinary and multicenter collaboration is ongoing and will facilitate moving this field forward to improve neurodevelopmental outcomes for children with CHD.
向读者介绍先天性心脏病(CHD)幸存者的神经认知特征、可能影响结局的危险因素,以及心脏神经发育护理的建议。
越来越多的文献表明,CHD 幸存者发生神经发育障碍的风险增加。多个因素影响每个患者的风险,这些因素可能从宫内开始,一直延伸到围手术期管理、手术考虑因素和长期临床护理。此外,社会人口因素可能会使这些风险更加复杂。对于患有严重 CHD 的儿童,建议进行连续的发育随访。
尽管存在一些增加风险的临床因素,但鉴于 CHD 儿童发育障碍的发生率较高,仍推荐进行连续评估。多学科和多中心合作正在进行中,这将有助于推动该领域的发展,改善 CHD 儿童的神经发育结局。