Heart and Circulation

Objective: To define the incidence of brain and kidney anomalies in newborns with significant congenital heart disease admitted to the cardiac intensive care unit at Nicklaus Children’s Hospital. Study Design: A retrospective chart review of head and renal ultrasound was studied for newborns who were admitted with significant congenital heart disease to Nicklaus Children’s Hospital cardiac intensive care unit from 2004 to 2010. As part of the institution protocol, genetic testing was also performed. Result: A total of 548 patient charts were reviewed; of which, 19% (104) had clinically significant head ultrasound abnormalities, and 50.7% (278) had renal ultrasound abnormalities. Patients with septal defects were more likely to have clinically significant head ultrasound abnormalities (40.0%) than those with other types of congenital heart disease (17.8%; P=0.0025). Premature patients and those with genetic abnormalities were more likely to have clinically significant head ultrasound abnormalities than term patients (28.4% versus 17.0%, P=.01) or those without genetic abnormalities (25.3% versus 15.9%; P=.049). There was no increase in renal ultrasound abnormalities among those with genetic defects (54.7% versus 52.7, P= 0.75). Patients with dysmorphism had a higher risk of clinically significant head ultrasound (24.5%) and renal ultrasound abnormalities (59.5%) than non-dysmorphic patients (15.9%, P=.031; 47.1%, P=.008, respectively). Conclusion: This study illustrates the high prevalence of renal and neurological abnormalities associated with congenital heart disease and confirms the utility of screening head and renal ultrasounds in newborns admitted with significant structural heart disease.