Neuromonitoring and follow-up in patients with congenital heart disease in Spain

Introduction

There is evidence of the high incidence of neurological abnormalities in patients with congenital heart disease (CHD). Despite this, perioperative neuromonitoring strategies and long-term follow-up protocols are not standardized in Spain.

Objective

The aim of our study was to describe current clinical practice in neuromonitoring, neuroimaging and neurodevelopmental follow-up in patients with CHD in Spanish hospitals that perform paediatric cardiac surgery (PCS).

Material and method

We conducted a survey by adapting a questionnaire originally developed by the European Association Brain and Congenital Heart Disease Consortium to collect data on aspects such as the implementation of perioperative neuromonitoring and the type of neuroimaging techniques and neurological follow-up performed. The questionnaire was distributed to the 19 Spanish hospitals that perform PCS.

Results

We received responses from 17 centres. Eighty-eight percent performed some type of preoperative neuroimaging and 81% postoperative monitoring. The most widely used technique was transfontanellar sonography. Fifty-six percent of the centres used some form of intraoperative neuromonitoring, most frequently near-infrared spectroscopy. Nineteen percent had an established protocol for the follow-up of these patients and 13% were in the process of developing it.

Conclusions

There is considerable heterogeneity in neuromonitoring, neuroimaging and neurologic follow-up practices in the management of patients with CHD in hospitals that perform PCS in Spain. These findings highlight the need to pursue a consensus in order to standardise neuromonitoring and neurologic follow-up strategies in children with CHD in Spain.