Neurorehabilitation in Patients with Congenital Heart Disease

Background: Progress in cardiovascular surgery and intensive care of children with congenital heart disease could reduce mortality considerably. Survival rate after surgery for complex congenital heart disease today is averaged out at ~95%. Therefore, disabling complications of other organs become more important, particularly neurologic complications. This can be seen in the increasing number of children getting neurological rehabilitation.

Main Part: Risk factors for neurological complications are diagnostic and interventional heart catheterization, surgery without and with heart-lung-machine, heart transplantations, resuscitation, ECMO (extracorporeal membrane oxygenation), arrhythmias, endocarditis. That may cause cerebral hemorrhages, thromboembolism and septic embolism as well as ischemia. In case of severe neurologic complications the neurological outcome may influence the decisions concerning future cardiac interventions. With examples neurologic rehabilitation of patients will be explained with severe hypoxic ischemia after arrhythmia with resuscitation, with multiple cerebral hemorrhage and multiple organ failure after cardiac surgery, and infarction of the middle cerebral artery after catheter intervention

Conclusion: Neurological rehabilitation in patients with complications after intervention or surgery of congenital heart disease is getting more important. Even after prolonged resuscitation, the outcome in this patient group can be surprisingly good. The neurologic outcome may influence further management concerning cardiological decisions.

Die Autoren geben an, dass kein Interessenkonflikt besteht.