{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:37:47Z","timestamp":1780515467100,"version":"3.54.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,4,9]]},"abstract":"\n Background<\/jats:title>\n \n As a result of medical and surgical advancements in the management of congenital heart disease (\n CHD<\/jats:styled-content>\n ), survival rates have improved substantially, which has allowed the focus of\n CHD<\/jats:styled-content>\n management to shift toward neurodevelopmental outcomes. Previous studies of the neuropathology occurring in\n CHD<\/jats:styled-content>\n focused on cases preceding 1995 and reported high rates of white matter injury and intracranial hemorrhage, but do not reflect improvements in management of\n CHD<\/jats:styled-content>\n in the past 2 decades. The purpose of this study is therefore to characterize the neuropathological lesions identified in subjects dying from\n CHD<\/jats:styled-content>\n in a more\u2010recent cohort from 2 institutions.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We searched the autopsy archives at 2 major children's hospitals for patients with cyanotic congenital cardiac malformations who underwent autopsy. We identified 50 cases ranging in age from 20 gestational weeks to 46\u00a0years. Acquired neuropathological lesions were identified in 60% (30 of 50) of subjects upon postmortem examination. The most common lesions were intracranial hemorrhage, most commonly subarachnoid (12 of 50; 24%) or germinal matrix (10 of 50; 20%), hippocampal injuries (10 of 50; 20%), and diffuse white matter gliosis (8 of 50; 16%). Periventricular leukomalacia was rare (3 of 50). Twenty\u2010six subjects underwent repair or palliation of their lesions. Of the 50 subjects, 60% (30 of 50) had isolated\n CHD<\/jats:styled-content>\n , whereas 24% (12 of 50) were diagnosed with chromosomal abnormalities (trisomy 13, 18, chromosomal deletions, and duplications) and 16% (8\/50) had multiple congenital anomalies.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In the modern era of pediatric cardiology and cardiac surgery, intracranial hemorrhage and microscopic gray matter hypoxic\u2010ischemic lesions are the dominant neuropathological lesions identified in patients coming to autopsy. Rates of more severe focal lesions, particularly periventricular leukomalacia, have decreased compared with historical controls.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013575","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T09:00:23Z","timestamp":1584954023000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Neuropathology of Congenital Heart Disease in an Inpatient Autopsy Cohort 2000\u20132017"],"prefix":"10.1161","volume":"9","author":[{"given":"Leigh A.","family":"Rettenmaier","sequence":"first","affiliation":[{"name":"University of Iowa Carver College of Medicine Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A.","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Iowa Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin E.","family":"Reinking","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Iowa Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela N.","family":"Viaene","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Children's Hospital of Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-4528","authenticated-orcid":false,"given":"Marco M.","family":"Hefti","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Iowa Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01886-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.05.059"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.947002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.008396"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32834aa583"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.05.073"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019881"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.01.002"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-005-1077-6"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.85.6.991"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3109\/15513819109065483"},{"key":"e_1_3_2_13_2","volume-title":"Cyanotic Heart Disease","author":"Ossa Galvis MM","year":"2019","unstructured":"Ossa Galvis MM, Mendez MD. Cyanotic Heart Disease. Treasure Island, FL: Statpearls; 2019."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(94)90061-2"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00313685"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2018.12.003"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13436"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2018.05.045"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.07.006"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.07.022"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.2350\/15-06-1663-OA.1"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.05.042"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.013575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:24:32Z","timestamp":1715599472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.013575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,9]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,4,9]]}},"alternative-id":["10.1161\/JAHA.119.013575"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.013575","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,9]]},"assertion":[{"value":"2019-06-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e013575"}}