{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:40:42Z","timestamp":1792809642237,"version":"4.5.0"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,28]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective was to quantify risks of hydrocephalus, cerebrospinal fluid (CSF) shunt placement, and shunt malfunction in children &lt; 3 years of age with congenital heart defect (CHD) versus matched controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was a multicenter retrospective cohort study conducted using TriNetX. Children &lt; 3 years with CHD were propensity score matched 1:1 to controls on the basis of demographic characteristics and comorbidities. Outcomes were hydrocephalus (ICD-10 code G91), CSF shunt placement, and shunt malfunction (ICD-10 T85.0). Associations were reported as risk ratios (RRs) with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 83,258 children with CHD and 418,476 controls, matching yielded 64,413 per group with excellent balance (all standardized mean differences &lt; 0.02). Compared to matched controls, CHD patients were associated with higher rates of hydrocephalus (1.1% vs 0.2%, RR 4.98, 95% CI 4.15\u20135.97), shunt placement (0.4% vs 0.04%, RR 9.11, 95% CI 6.12\u201313.55), and shunt malfunction (2.5% vs 0.4%, RR 5.75, 95% CI 5.07\u20136.53) (all p &lt; 0.001). Across physiology, elevations were consistent; within CHD, the rate of shunt malfunction was higher in patients with cyanotic defects than those with acyanotic defects (4.6% vs 2.5%, RR 1.86, 95% CI 1.61\u20132.14, p &lt; 0.001). The strongest associations were observed in defect types most frequently encountered during the first 3 years of life. Hydrocephalus risk was increased in patients with patent ductus arteriosus (PDA) (2.2% vs 0.4%, RR 5.12, 95% CI 3.93\u20136.68), atrial septal defect (ASD) (1.1% vs 0.3%, RR 4.47, 95% CI 3.65\u20135.47), atrioventricular septal defect (AVSD) (1.0% vs 0.2%, RR 4.32, 95% CI 3.57\u20135.23), ventricular septal defect (VSD) (0.9% vs 0.3%, RR 2.79, 95% CI 2.01\u20133.88), and coarctation (2.1% vs 0.6%, RR 3.50, 95% CI 1.74\u20137.05). Shunt placement was likewise more common in patients with PDA (0.8% vs 0.1%, RR 9.14, 95% CI 5.27\u201315.87), ASD (0.4% vs 0.1%, RR 7.84, 95% CI 5.17\u201311.89), AVSD (0.4% vs 0.05%, RR 7.85, 95% CI 5.22\u201311.80), and VSD (0.3% vs 0.1%, RR 4.33, 95% CI 2.31\u20138.11) (all p &lt; 0.001). Shunt malfunction was most pronounced in patients with tetralogy of Fallot (7.4% vs 0.7%, RR 11.30, 95% CI 5.94\u201321.49) and coarctation (6.8% vs 0.6%, RR 11.60, 95% CI 6.10\u201322.05) and remained elevated across septal lesions (AVSD 2.5%, ASD 2.4%, and VSD 3.1%) and PDA (3.8%) (all p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>CHD is associated with increased risk of hydrocephalus, shunting, and shunt malfunction in early childhood. Risks increase with septal lesions, PDA, and coarctation, with a higher rate of shunt malfunction in patients with cyanotic physiology. These findings support early cardiology-neurosurgery surveillance and care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.3.peds25692","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:01:36Z","timestamp":1787702496000},"page":"1-12","source":"Crossref","is-referenced-by-count":0,"title":["Association of congenital heart disease with hydrocephalus and shunt dysfunction in early childhood: a comparative cohort study"],"prefix":"10.3171","author":[{"given":"Barbara","family":"Buccilli","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Texas Medical Branch at Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srivats","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Robledo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Miami, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Manjrekar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo","family":"Haddad Santos","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo (USP), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett A.","family":"Whittemore","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"12","key":"b1","series-title":"J Am Coll Cardiol","first-page":"1890","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman JI","year":"2002","unstructured":"Hoffman JI, Kaplan S. 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