Cerebral hemodynamics in early adolescents with congenital heart disease after infant open-heart surgery

Fetuses and infants with congenital heart disease (CHD) show altered cerebral hemodynamics. However, little is known about whether those alterations persist throughout childhood. We assessed cerebral hemodynamics in 34 adolescents with CHD aged 10–15 years (35% females), who had infant open-heart surgery, and 49 healthy controls (51% females), and investigated the relationship between cerebral hemodynamics and executive functions. Using phase-contrast magnetic resonance imaging (pcMRI) we measured the average and peak blood velocity and average blood flow in the bilateral internal carotid arteries (ICA) and the average blood velocity and flow in the internal jugular veins (IJV). ICA blood flow was used to calculate the indexed cerebral blood flow (iCBF) adjusted for total brain volume. Vertebral arteries (VA) were analyzed post-hoc using a vessel angle correction. Cerebral hemodynamic parameters were compared between patients and healthy controls and correlated with an executive function summary score. Differences in anterior hemodynamic parameters between patients with CHD vs. healthy controls did not survive FDR correction (all p>0.1, β:0.004–0.297), but lower blood velocity and flow in the left VA in patients with CHD remained significant after FDR-correction (both corrected p=0.044, β=0.248–0.314). Hemodynamic parameters were not significantly associated with the executive function summary score (all p>0.8, β:0.023–0.119). Overall, patients with CHD who underwent infant open-heart surgery have widely preserved anterior cerebral hemodynamics during adolescence, but demonstrate alterations in the posterior circulation. Further, hemodynamic parameters show no association with executive functions and thus, may not be a risk factor for executive function impairments.