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Cardiology patient page. Neurodevelopmental outcomes in congenital heart disease.

As improved treatments for congenital heart disease (CHD) have increased life expectancy, neurodevelopmental impairments have been observed in many survivors. These impairments include developmental delays, difficulty in school, and challenges living independently. Understanding the causes of these impairments and minimizing their impact are important goals to allow survivors to have the best possible quality of life.

CHD may affect the brain in several ways. First, the heart pumps blood that carries nutrients and oxygen to the brain to allow it to grow and develop. Some types of CHD may reduce the amount of blood reaching the brain or the oxygen content of the blood. Starting in the fetal period, reduced blood flow and oxygen content may impede brain maturation. Indeed, full-term babies with some types of heart defects have brain maturity that is about 1 month delayed (ie, similar to those of premature babies born at 36 weeks).1

Brain injury may also occur in CHD. Brain immaturity increases the risk of brain injury with stresses such as labor and delivery, blood pressure instability, or infection. White matter, a tissue connecting different regions of the brain, is particularly vulnerable to injury. White matter injury …