Table 1a.

Preoperative Risk Factors for Perioperative Cerebral Injuries and Poor Neurodevelopmental Outcomes in Children with CHD

Risk Factor	Examples
Genetic syndromes associated with abnormal neurodevelopment	Trisomy 21, velocardiofacial syndrome, DiGeorge, Turner,Williams, Alagille, CHARGE, and VACTERL [7]
Abnormal in utero neurodevelopment	Delayed myelination, immature sulcation, decreased parenchymal volume [10]
Congenital CNS abnormalities	Intracranial venous and cystic malformations [10]
Complicated pre-operative course	Prematurity, IUGR, sepsis, mechanical ventilation, hemodynamic instability, persistent hypoxia with arterial saturation less than 85% [6,9], persistent acidosis [6], IVH [6,7], poor glycemic control [1], hyperthermia [1], multiorgan dysfunction, and other comorbidities
Brain injuries acquired pre-operatively	Injuries involving both superficial and deep white matter, focal strokes [middle, posterior, and anterior cerebral artery distributions], hemorrhages [intraventricular, subependymal, subdural] [10]

CHARGE, coloboma, heart defect, atretic choanae, retardation of growth and development, genitourinary anomalies, ear abnormalities; VACTERL: vertebral anomalies, anal atresia, cardiac anomaly, tracheoesophageal fistula, renal and limb abnormalities; IUGR, intra-uterine growth retardation; IVH, intraventricular hemorrhage.