Neurological Sequelae Following Pediatric Cardiac Interventions

Hala  Agha; Mai Mahmoud Hussien; Marian Y Girgis; Omneya Gamal Eldin  Afify; Mervat Haroun

doi:10.3889/oamjms.2021.5581

Authors

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

DOI:

https://doi.org/10.3889/oamjms.2021.5581

Keywords:

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

Abstract

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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