MSGID: 1:317/3 63db3c68   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    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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