Abstract

A hemodynamic disturbance in children with congenital heart defects (CHD) impairs cerebral perfusion resulting into brain neural injury. Neural injury in CHDs patients can occur prenatally, postnatal or during surgical repair of the defects (reperfusion injury) often following hypoxia induced oxidative stress. The brain subventicular zone (SVZ) contain postnatal niche of neural stem cells. SVZ cells are very sensitive to hypoxia and may be damaged in children with CHDs. Oligodendriocytes and myelinated fibers are documented to be most vulnerable in conditions of diminished oxygen supply to the brain thus frequently damaged in patient with CHDs. The evaluation of brain associated consequences is frequently overlooked in many cases of CHDs. Therefore, this mini review put forward the impact of CHDs on brain white matter, cognitive and behavior. In addition, it highlights the important infant cognitive evaluation tools and novel techniques used to study the brain white matter.

Keywords:Congenital heart diseases CHDs; White matter injury; Brain volume; Cortical thickness; Psychomotor development; Cognitive; Behavior

Abbrevations:CHD: Congenital Heart Defects; SVS: Sub Ventricular Zone; HLHS: Hypoplastic Left Heart Syndrome; TOF: Tetralogy of Fallot; TGV: Transposition of Greater Vessels