{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:06:43Z","timestamp":1791544003830,"version":"4.3.4"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Infants with congenital heart disease require early lifesaving heart surgery, which increases risk for brain injury and neurodevelopmental delay. Cerebral microhemorrhages (CMH) are frequently seen after surgery, but whether they are benign or constitute injury is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              One hundred ninety\u2010two infants with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass were evaluated with pre\u2010 (n=183) and\/or postoperative (n=162) magnetic resonance imaging. Perioperative risk factors for CMH and neurodevelopmental outcomes were analyzed using linear regression. Eighteen\u2010month neurodevelopmental outcomes were assessed in a subset of patients (n=82). The most common congenital heart disease subtypes were hypoplastic left heart syndrome (37%) and transposition of the great arteries (33%). Forty\u2010two infants (23%) had CMH present on magnetic resonance imaging presurgery and 137 infants (85%) postsurgery. We found no significant risk factors for preoperative CMH. In multivariable analysis, neurodevelopmental duration (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), use of extracorporeal membrane oxygenation support (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0005), postoperative seizure(s) (\n              <jats:italic>P<\/jats:italic>\n              =0.02), and lower birth weight (\n              <jats:italic>P<\/jats:italic>\n              =0.03) were associated with new or worsened CMH postoperatively. A higher CMH number was associated with lower motor scores (\n              <jats:italic>P<\/jats:italic>\n              =0.01) at 18\u2009months.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">CMH are common imaging findings in infants with congenital heart disease, particularly after cardiopulmonary bypass conferring adverse impact on neurodevelopmental outcomes at 18\u2009months. Longer duration of cardiopulmonary bypass and extracorporeal membrane oxygenation use demonstrated greatest risk for developing CMH. However, the presence of CMH on preoperative scans indicates yet unidentified nonperioperative risk factors. Neuroprotective strategies to mitigate CMH risk may improve neurodevelopmental outcomes in this vulnerable population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.035359","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T10:12:32Z","timestamp":1738577552000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Cerebral Microhemorrhages in Children With Congenital Heart Disease: Prevalence, Risk Factors, and Association With Neurodevelopmental Outcomes"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6702-7097","authenticated-orcid":false,"given":"Kristen N.","family":"Andersen","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sicong","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Biostatistics Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5196-2339","authenticated-orcid":false,"given":"Brian R.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology Children\u2019s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marin","family":"Jacobwitz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake","family":"Breimann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jharna","family":"Jahnavi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3025-6061","authenticated-orcid":false,"given":"Wesley B.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5113-0310","authenticated-orcid":false,"given":"Tiffany S.","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-5604","authenticated-orcid":false,"given":"J. William","family":"Gaynor","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1346-427X","authenticated-orcid":false,"given":"Arastoo","family":"Vossough","sequence":"additional","affiliation":[{"name":"Department of Radiology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-8171","authenticated-orcid":false,"given":"Rui","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Biostatistics Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4080-843X","authenticated-orcid":false,"given":"Daniel J.","family":"Licht","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"},{"name":"Perinatal Pediatrics Institute Children\u2019s National Hospital Washington DC USA"},{"name":"Department of Neurology University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-0231","authenticated-orcid":false,"given":"Evelyn K.","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neurology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"},{"name":"Department of Neurology University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3825"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1959"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsl047"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-4055"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048202"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000829"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.10.025"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.760819"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067393"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.03.001"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025516"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000199847.96188.12"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493019830594"},{"key":"e_1_3_2_15_2","first-page":"637","article-title":"Histopathologic analysis of foci of signal loss on gradient\u2010echo T2*\u2010weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy\u2010related microbleeds","volume":"20","author":"Fazekas F","year":"1999","unstructured":"Fazekas F, Kleinert R, Roob G, Kleinert G, Kapeller P, Schmidt R, Hartung HP. 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