Key result
Cardiopulmonary bypass in infants with CHD is linked to reduced white matter and thalamus stiffness.
Why the study?
Does cardiac surgery with cardiopulmonary bypass alter periventricular white matter and thalamic stiffness as measured by shear wave elastography in infants with congenital heart disease?
Observational (n=43)
No
Does cardiac surgery with cardiopulmonary bypass alter periventricular white matter and thalamic stiffness as measured by shear wave elastography in infants with congenital heart disease?
Shear wave elastography is a feasible bedside tool that detects significant reductions in periventricular white matter and thalamic stiffness 24 hours after congenital cardiac surgery in infants.
SWE may detect PVWM/thalamic stiffness changes post-CPB in infants; leaves open prognostic value and need for prospective validation.
Objective To quantitatively evaluate stiffness changes in the periventricular white matter (PVWM) and thalamus (TH) in infants undergoing congenital cardiac surgery using shear wave elastography (SWE). Design A prospective observational study. Setting Single-center study based at a tertiary care center. Patients Forty-three infants aged zero-to-six months with congenital heart disease (CHD) undergoing cardiac surgery with cardiopulmonary bypass (CPB) were enrolled. Interventions SWE was performed to measure periventricular white matter and thalamic stiffness before and after surgery. Measurements and Main Results No significant correlation was observed between age and the stiffness of either PVMW or TH, both before and after surgery. Significant postoperative reductions were observed in mean stiffness of PVMW (1.22 ± 0.14 m/s vs. 1.18 ± 0.14 m/s, p = 0.014) and TH (1.54 ± 0.15 m/s vs. 1.50 ± 0.15 m/s, p = 0.031). Regional analysis of PVWM and TH indicated a significant postoperative decrease in tissue stiffness, with notable reductions observed in the body portion of PVWM (1.24 ± 0.13 m/s vs. 1.18 ± 0.15 m/s, p = 0.046), the caudal portion of PVWM (1.22 ± 0.14 m/s vs. 1.18 ± 0.13 m/s, p = 0.045), and the caudal portion of TH (1.53 ± 0.16 m/s vs. 1.45 ± 0.16 m/s, p = 0.014). Consistently, PVWM demonstrated lower stiffness than TH, both before surgery (1.22 ± 0.14 m/s vs. 1.54 ± 0.15 m/s, p < 0.001) and after surgery (1.18 ± 0.14 m/s vs. 1.50 ± 0.15 m/s, p < 0.001). Conclusions SWE identified significant postoperative reductions in the stiffness of PVWM and TH in infants with CHD. The body and caudal PVWM, as well as caudal TH, showed the most prominent changes. PVWM consistently presented lower stiffness than TH during the entire perioperative period. SWE proves feasible for quantitative evaluation of minor cerebral changes in affected infants during the perioperative period.
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Sun et al. (2026) conducted an observational in Congenital heart disease (n=43). Cardiac surgery with cardiopulmonary bypass vs. Preoperative baseline was evaluated on Mean stiffness of periventricular white matter (PVWM) in m/s (p=0.014). Cardiac surgery with cardiopulmonary bypass significantly reduced the mean stiffness of periventricular white matter (from 1.22 to 1.18 m/s) and thalamus (from 1.54 to 1.50 m/s) in infants with congenital heart disease.
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