Congenital heart disease and brain development.
ABSTRACT Brain and heart development occur simultaneously in the human fetus. Given the depth and complexity of these shared morphogenetic programs, it is perhaps not surprising that disruption of organogenesis in one organ will impact the development of the other. Newborns with congenital heart disease show a high frequency of acquired focal brain injury on sensitive magnetic resonance imaging studies in the perioperative period. The surprisingly high incidence of white matter injury in these term newborns suggests a unique vulnerability and may be related to a delay in brain development. These abnormalities in brain development identified with MRI in newborns with congenital heart disease might reflect abnormalities in cerebral blood flow while in utero. A complete understanding of the mechanisms of white matter injury in the term newborn with congenital heart disease will require further investigation of the timing, extent, and causes of delayed fetal brain development in the presence of congenital heart disease.
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ABSTRACT: This paper is concerned with predicting the occurrence of Periventricular Leukomalacia (PVL) using vital data which are collected over a period of twelve hours after neonatal cardiac surgery. The vital data contain heart rate (HR), mean arterial pressure (MAP), right atrium pressure (RAP), and oxygen saturation (SpO2). Various features are extracted from the data and are then ranked so that an optimal subset of features that have the highest discriminative capabilities can be selected. A decision tree (DT) is then developed for the vital data in order to identify the most important vital measurements. The DT result shows that high amplitude 20 minutes variations and low sample entropy in the data is an important factor for prediction of PVL. Low sample entropy represents lack of variability in hemodynamic measurement, and constant blood pressure with small fluctuations is an important indicator of PVL occurrence. Finally, using the different time frames of the collected data, we show that the first six hours of data contain sufficient information for PVL occurrence prediction.Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 07/2013; 2013:7080-7083. DOI:10.1109/EMBC.2013.6611189
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ABSTRACT: This paper is concerned with the prediction of the occurrence of periventricular leukomalacia (PVL) that occurs in neonates after heart surgery. The data which is collected over a period of 12 hours after cardiac surgery contains vital measurements as well as blood gas measurements with different resolutions. Vital data measured using near-inferred spectroscopy (NIRS) at the sampling rate of 0.25 Hz and blood gas measurement up to 12 times with irregular time intervals for 35 patients collected at Children's Hospital of Philadelphia (CHOP) are used for this study. Features derived from the data include statistical moments (mean, variance, skewness and kurtosis), trend and minimum and maximum values of the vital data and rate of change, time weighted mean and a custom defined out of range index (ORI) for the blood gas data. A decision tree is developed for the vital data in order to identify the most important vital measurements. In addition, a decision tree is developed for blood gas data to find important factors for the prediction of PVL occurrence. Results show that in the blood gas data, maximum rate of change of concentration of bicarbonate ions in blood (HCO(3)) and minimum rate of change of partial pressure of dissolved CO(2) in the blood (PaCO(2)) are the two most important factors for prediction of the PVL. Also important are the kurtosis of heart rate and hemoglobin values.Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 08/2012; 2012:5931-4. DOI:10.1109/EMBC.2012.6347344
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ABSTRACT: We studied brain structure abnormalities in adolescents and young adults who had undergone the neonatal arterial switch operation for transposition of the great arteries and related them to the neurologic and psycho-intellectual outcomes.Journal of Thoracic and Cardiovascular Surgery 05/2014; 148(5). DOI:10.1016/j.jtcvs.2013.10.087 · 3.99 Impact Factor