Neurological Sequelae Following Pediatric Cardiac Interventions


  • Hala Mounir Agha Department of Pediatrics, Pediatric Cardiology Division, Specialized Pediatric Hospital, Cairo University
  • Mai Mahmoud Hussien Department of Pediatrics, National institute of neuromotor system, General organization of Teaching hospitals and Institutes
  • Marian Y Girgis Department of Pediatrics, Pediatric Neurology Division, Specialized Pediatric Hospital, Cairo University
  • Omneya Gamal Eldin Afify Department of Pediatrics, Pediatric Neurology Division, Specialized Pediatric Hospital, Cairo University
  • Mervat Ahmed Haroun Department of Pediatrics, Pediatric Neurology Division, Specialized Pediatric Hospital, Cairo University



Congenital heart, Neurological insult, Open surgery, Closed surgery, Catheterization


AIM: The aim of the present study was to assess neurological sequelae within 30 days of surgical or cardiac catheter interventions in infants and children.

METHOD: In this cross-sectional study, we evaluated all patients who developed neurological problems after cardiac interventions either by surgery or by catheter by clinical evaluation, brain imaging, and electrophysiological studies.

RESULTS: Among 1200 procedures were performed; 895 (74.6%) were cardiac catheterizations either diagnostic or intervention, 167 (13.9%) were open-heart surgery, and 138 (11.5%) were closed heart surgery. The overall incidence of post-procedure neurological dysfunction in the studied population was 3.4%. The differences between the three groups were statistically significant (p < 0.0001(. In our series, the neurological complications were in the form of disturbed conscious level in 2/41 (4.9%), impaired motor function in 11/41 (26.8%), impaired mental functions in 6/41(14.6%), hyperreflexia in 27/41 (65.9%), and seizures in 38/41 (92.7%). The most common presentation of seizures was in the form of focal fits 21/41 (51.2%), followed by generalized fits in 15/41(36.6%) and then myoclonic fits 2/41 (4.9%).

CONCLUSION: Seizures are the most common complication following cardiac interventions in pediatric age and the highest percentage following open heart surgery.


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Kelly CJ, Arulkumaran S, Pereira CT, Cordero-Grande L, Hughes EJ, Teixeira RP, et al. Neuroimaging findings in newborns with congenital heart disease prior to surgery: An observational study. Arch Dis Childhood. 2019;104(11):1042-8. PMid:31243012

Gamal AH, Ahmed EM, Ahmed IE, Omar SA. Postoperative complications in pediatric cardiac surgery patients done in a tertiary hospital. J Curr Med Res Pract. 2020;5(2):121.

Sutherasan Y, Vargas M, Brunetti I, PPelosi. Ventilatory targets after cardiac arrest. Minerva Anestesiol. 2015;81(1):39-51. PMid:24642487

Gofton TE, Chu MW, Norton L, Fox SA, Chase L, Murkin JM, et al. A prospective observational study of seizures after cardiac surgery using continuous EEG monitoring. Neurocritical Care. 2014;21(2):220-7. PMid:24710654

Guo Z, Hu RJ, Zhu DM, Zhu ZQ, Zhang HB, Wang W. Usefulness of deep hypothermic circulatory arrest and regional cerebral perfusion in children. Ther Hypothermia Temp Manag. 2013;3(3):126-31. PMid:24066266

Hsu CJ, Weng WC, Peng SS, Lee WT. Early-onset seizures are correlated with late-onset seizures in children with arterial ischemic stroke. Stroke. 2014;45(4):1161-3. PMid:24595587

Mahle WT, Tavani F, Zimmerman RA, Nicolson SC, Galli KK, Gaynor JW, et al. An MRI study of neurological injury before and after congenital heart surgery. Circulation. 2002;106(Suppl 12):I109-14. PMid:12354718

Silva KP, Rocha LA, Leslie AT, Guinsburg R, Silva CM, Nardozza LM, et al. Newborns with congenital heart diseases: Epidemiological data from a single reference center in Brazil. J Prenat Med. 2014;8(1-2):11-6. PMid:25332754

Gilboa SM, Salemi JL, Nembhard WN, Fixler DE, Correa A. Mortality resulting from congenital heart disease among children and adults in the United States, 1999 to 2006. Circulation. 2010;122(22):2254-63. PMid:21098447

Snookes SH, Gunn JK, Eldridge BJ, Donath SM, Hunt RW, Galea MP. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease. Pediatrics. 2010;125(4):e818-27.


Algra SO, Jansen NJ, van der Tweel I, Schouten AN, Groenendaal F, Toet M, et al. Neurological injury after neonatal cardiac surgery: A randomized, controlled trial of 2 perfusion techniques. Circulation. 2014;129(2):224-33. PMid:24141323

Liu XY, Wong V, Leung M. Neurologic complications due to catheterization. Pediatr Neurol. 2001;24(4):270-5. PMid:11377101

Jafri SK, Ehsan L, Abbas Q, Ali F, Chand P, Ul Haque A. Frequency and outcome of acute neurologic complications after congenital heart disease surgery. J Pediatr Neurosci. 2017;12(4):328-31. PMid:29675070

Meyer S, Shamdeen MG, Shatat M, Schäfers HJ, Gortner L, Gottschling S, et al. The role of EEG recordings in children undergoing cardiac surgery for congenital heart disease. J Pediatr Intensive Care. 2012;1(1):37-41. pic-2012-007 PMid:31214383

Asakai H, Cardamone M, Hutchinson D, Stojanovski B, Galati JC, Cheung MM, et al. Arterial ischemic stroke in children with cardiac disease. Neurology. 2015;85(23):2053-9. https:// PMid:26408496

Agarwal HS, Wolfram KB, Saville BR, Donahue BS, Bichell DP. Postoperative complications and association with outcomes in pediatric cardiac surgery. J Thorac Cardiovasc Surg. 2014;148(2):609-16. PMid:24280709

Beca J, Gunn JK, Coleman L, Hope A, Reed PW, Hunt RW, et al. New white matter brain injury after infant heart surgery is associated with diagnostic group and the use of circulatory arrest. Circulation. 2013;127(9):971-9. PMid:23371931

Peyvandi S, Kim H, Lau J, Barkovich AJ, Campbell A, Miller S, et al. The association between cardiac physiology, acquired brain injury, and postnatal brain growth in critical congenital heart disease. J Thorac Cardiovasc Surg. 2018;155(1):291-300. PMid:28918207

Andropoulos DB, Easley RB, Brady K, McKenzie ED, Heinle JS, Dickerson HA, et al. Changing expectations for neurological outcomes after the neonatal arterial switch operation. Ann Thorac Surg. 2012;94(4):1250-6. PMid:22748448

Rappaport LA, Wypij D, Bellinger DC, Helmers SL, Holmes GL, Barnes PD, et al. Relation of seizures after cardiac surgery in early infancy to neurodevelopmental outcome. Circulation. 1998;97(8):773-9. PMid:9498541

Von Rhein M, Dimitropoulos A, Buechel ER, Landolt MA, LatalB. Risk factors for neurodevelopmental impairments in school-age children after cardiac surgery with full-flow cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2012;144(3):577-83. PMid:22405675




How to Cite

Agha H, Hussien MM, Girgis MY, Afify OGE, Haroun M. Neurological Sequelae Following Pediatric Cardiac Interventions. Open Access Maced J Med Sci [Internet]. 2021 Jan. 31 [cited 2023 Sep. 27];9(B):137-43. Available from: