Postoperative improvement of brain maturation in infants with congenital heart disease

Children with severe congenital heart disease are at risk for neurodevelopmental impairments. We examined brain maturation in infants undergoing neonatal cardiopulmonary bypass surgery or hybrid procedure for hypoplastic left heart syndrome compared to controls. This is a prospective cohort study on term-born infants with congenital heart disease with cerebral MRI pre- and postoperatively. Healthy infants served as controls. Brain maturation was measured using a semi-quantitative scoring system. The progress of brain maturation from the preoperative to postoperative MRI within patients was compared. Neurodevelopment was assessed at one year with the Bayley Scales of Infant and Toddler Development III. A total of 92 patients with congenital heart disease and 46 controls were studied. Median total maturation score in patients was 12 (IQR 10.6-13.0) preoperatively and 14 (12.0-15.0) postoperatively, in controls it was 14 (13-0-15.0). Median time interval between scans was 19 days (IQR 14 – 26). After correction for postmenstrual age at MRI, the pre- and postoperative maturation score was lower in patients compared to controls (preoperative p=0.01, postoperative p=0.03) and increased between pre- and postoperative assessment (p=