Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Periventricular leukomalacia is common after neonatal cardiac surgery.

Publication ,  Journal Article
Galli, KK; Zimmerman, RA; Jarvik, GP; Wernovsky, G; Kuypers, MK; Clancy, RR; Montenegro, LM; Mahle, WT; Newman, MF; Saunders, AM; Nicolson, SC ...
Published in: J Thorac Cardiovasc Surg
March 2004

OBJECTIVES: Periventricular leukomalacia is necrosis of the cerebral white matter adjacent to the lateral ventricles and results from injury to immature oligodendroglia. In infants without congenital heart disease, periventricular leukomalacia is associated with an increased incidence of developmental delay and attention deficit/hyperactivity disorder. The incidence of periventricular leukomalacia and the risk factors for development of periventricular leukomalacia after infant cardiac surgery are not known. METHODS: Magnetic resonance imaging of the brain was performed 6 to 14 days after cardiac surgery utilizing cardiopulmonary bypass with or without deep hypothermic circulatory arrest in 105 neonates and infants < or = 6 months of age. RESULTS: Median age at surgery was 6 days (range 1-178), with 82 neonates (age < or = 30 days). Periventricular leukomalacia was found in 44 of the neonates (54%) compared with 1 of 23 infants (4%). Forward logistic regression using age at surgery as a continuous variable identified a model containing longer total support time (cardiopulmonary bypass plus deep hypothermic circulatory arrest), lower systolic blood pressure at cardiac intensive care unit admission postoperatively, lower minimum diastolic blood pressure, and Po(2) in the first 48 hours after surgery. When age at surgery was considered as a dichotomous variable (neonate versus infant), younger age at surgery replaced systolic blood pressure, Po(2), and total support time in the model. Lower minimum diastolic blood pressure was a significant risk factor in both models. CONCLUSIONS: Periventricular leukomalacia was found in >50% of neonates after cardiac surgery but rarely in older infants. Hypoxemia and hypotension in the early postoperative period, particularly diastolic hypotension, may be important risk factors for periventricular leukomalacia.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

March 2004

Volume

127

Issue

3

Start / End Page

692 / 704

Location

United States

Related Subject Headings

  • Risk Factors
  • Respiratory System
  • Oxygen
  • Male
  • Magnetic Resonance Imaging
  • Logistic Models
  • Leukomalacia, Periventricular
  • Infant, Newborn
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Galli, K. K., Zimmerman, R. A., Jarvik, G. P., Wernovsky, G., Kuypers, M. K., Clancy, R. R., … Gaynor, J. W. (2004). Periventricular leukomalacia is common after neonatal cardiac surgery. J Thorac Cardiovasc Surg, 127(3), 692–704. https://doi.org/10.1016/j.jtcvs.2003.09.053
Galli, Kristin K., Robert A. Zimmerman, Gail P. Jarvik, Gil Wernovsky, Marijn K. Kuypers, Robert R. Clancy, Lisa M. Montenegro, et al. “Periventricular leukomalacia is common after neonatal cardiac surgery.J Thorac Cardiovasc Surg 127, no. 3 (March 2004): 692–704. https://doi.org/10.1016/j.jtcvs.2003.09.053.
Galli KK, Zimmerman RA, Jarvik GP, Wernovsky G, Kuypers MK, Clancy RR, et al. Periventricular leukomalacia is common after neonatal cardiac surgery. J Thorac Cardiovasc Surg. 2004 Mar;127(3):692–704.
Galli, Kristin K., et al. “Periventricular leukomalacia is common after neonatal cardiac surgery.J Thorac Cardiovasc Surg, vol. 127, no. 3, Mar. 2004, pp. 692–704. Pubmed, doi:10.1016/j.jtcvs.2003.09.053.
Galli KK, Zimmerman RA, Jarvik GP, Wernovsky G, Kuypers MK, Clancy RR, Montenegro LM, Mahle WT, Newman MF, Saunders AM, Nicolson SC, Spray TL, Gaynor JW. Periventricular leukomalacia is common after neonatal cardiac surgery. J Thorac Cardiovasc Surg. 2004 Mar;127(3):692–704.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

March 2004

Volume

127

Issue

3

Start / End Page

692 / 704

Location

United States

Related Subject Headings

  • Risk Factors
  • Respiratory System
  • Oxygen
  • Male
  • Magnetic Resonance Imaging
  • Logistic Models
  • Leukomalacia, Periventricular
  • Infant, Newborn
  • Infant
  • Humans