Embolic Foreign Material in the Central Nervous System of Pediatric Autopsy Patients With Instrumented Heart Disease

Journal of Neuropathology and Experimental Neurology
Matthew TorreRebecca D Folkerth

Abstract

Upon detection of foreign-body embolization to the central nervous system (CNS) following a specific invasive cardiovascular procedure in 1 autopsied child, we undertook a quality assurance analysis to determine whether other patients had had similar events. Autopsies of all infants and children with history of cardiac catheterization, heart surgery on cardiopulmonary bypass, and/or extracorporeal membrane oxygenation over a 5-year period at a single tertiary care institution were reviewed for light-microscopic evidence of foreign material. Of the 24 patients meeting clinical criteria (13 females, 11 males; ages 6 days to 20 years, median age 7.5 months), 8 (33%) had foreign embolic material to the CNS. The material was associated with a cellular inflammatory reaction in all cases, with a subset associated with infarcts. No embolic foreign material was detected in 14 age-matched patients without history of cardiovascular procedures. Particles acquired from ex vivo manipulation of a catheter type utilized in at least 1 of the affected patients demonstrated similar histologic characteristics. We conclude that, in addition to recognized risks of hypoxic-ischemic brain damage in congenital cardiopulmonary disease, potential brain i...Continue Reading

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Citations

Jul 8, 2020·Neurology·Arnold J SansevereRobert C Tasker
Oct 19, 2017·Journal of Neuropathology and Experimental Neurology·Rashi I MehtaRupal I Mehta
Dec 20, 2019·Insights Into Imaging·Alessandra D'AmicoArturo Brunetti
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Jul 6, 2021·The Neuroradiology Journal·Thomas MellemkjærClaus Z Simonsen

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