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Cardiopathies congénitales et développement cérébral

  • Conference paper
41es Journées nationales de la Société Française de Médecine Périnatale (Grenoble 12–14 octobre 2011)

  • 258 Accesses

Résumé

Les cardiopathies congénitales constituent une cause fréquente de morbidité pédiatrique. Elles sont diagnostiquées chez 6 à 8 pour mille naissances vivantes. Plus de 50 % de ces enfants auront besoin d’une chirurgie cardiaque à cœur ouvert. L’amélioration de la survie de ces enfants s’est cependant accompagnée d’une augmentation des déficits neurologiques particulièrement des troubles neurocognitifs. L’origine des lésions cérébrales au décours des cardiopathies congénitales est multifactorielle: génétique, fœtale mais aussi acquise en postnatale au moment de la réparation chirurgicale et de la période qui suit. La grande fréquence des lésions cérébrales diagnostiquées à l’IRM en période préopératoire souligne cependant l’importance des anomalies structurales cérébrales associées aux malformations cardiaques. La fréquence particulière des lésions de la substance blanche observées dans certaines cardiopathies complexes pourrait s’apparenter aux lésions observées chez le nouveau-né prématuré et être expliquées par un certain degré d’immaturité cérébrale. Ces anomalies développementales augmenteraient la vulnérabilité du cerveau aux lésions acquises qui pourraient survenir pendant la chirurgie ou en période postopératoire. Une meilleure compréhension des mécanismes des lésions cérébrales ainsi que du moment de leur survenue aidera sûrement à la mise en place de stratégies neuroprotectrices dans le but d’améliorer le devenir neurologique de ces enfants.

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  1. E. Saliba
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Saliba, E. (2011). Cardiopathies congénitales et développement cérébral. In: 41es Journées nationales de la Société Française de Médecine Périnatale (Grenoble 12–14 octobre 2011). Springer, Paris. https://doi.org/10.1007/978-2-8178-0257-2_16

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  • DOI: https://doi.org/10.1007/978-2-8178-0257-2_16

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0256-5

  • Online ISBN: 978-2-8178-0257-2

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