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Research Snapshot Theater: Cardiovascular, Adult and Pediatric

Neuroimaging Outcomes in Pediatric Congenital Heart Disease Post-Cardiopulmonary Bypass and ECMO

Tuesday, March 24, 2026
11:15 AM - 12:15 PM Central Time
Location: Connections Central - RST 04
  • FB

    Farah Bshesh, MD

    UT Southwestern Children's Medical Center, Texas

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • AK

    Annette Kurian, BS

    Medical Student
    University of Texas Southwestern

    Disclosure information not submitted.

  • ZA

    Zoey Abel, BA

    Medical Student
    University of Texas Southwestern

    Disclosure information not submitted.

  • AA

    Ashley Ajaq, BS

    Pharmacy Intern
    Children's Medical Center

    Disclosure information not submitted.

  • MM

    M Craig Morriss, MD

    Professor in the Department of Radiology
    University of Texas Southwestern

    Disclosure information not submitted.

  • SS

    Sumit Singh, MD

    Associate Professor of Radiology
    University of Texas Southwestern

    Disclosure information not submitted.

  • LR

    Lakshmi Raman, MD

    Professor in the Department of Pediatrics
    University of Texas Southwestern

    Disclosure information not submitted.

Introduction: Children with congenital heart disease (CHD) are at high risk for abnormal brain development and brain injury, especially after cardiopulmonary bypass (CPB). The effect of these injuries on functional outcomes remains uncertain. Use of extracorporeal membrane oxygenation (ECMO) has increased in CHD patients postoperatively. Prior studies show that routine head CT or MRI in ECMO patients identifies injuries missed by clinical exam or head ultrasound. Notably, these studies have excluded CHD patients. This study aims to evaluate head CT and MRI findings in CHD patients post-CPB and compare findings between those who did and did not receive ECMO support. We also aim to correlate imaging results with the functional status of patients using the functional status score (FSS).


Methods: A single-center retrospective cohort study was conducted of CHD patients who underwent CPB from 2019-2021.  Patients who had a post-operative head CT or brain MRI within one year of their surgery were identified and stratified based on ECMO use postoperatively. A previously validated neuroimaging scoring system was used to evaluate and score brain imaging. Preoperative imaging was also scored when available. FSS was evaluated at the date of discharge. Data collection and analysis is still ongoing.


Results: A total of 125 children who had corrective heart surgery on CPB from 2019-2021 had postoperative neuroimaging within one year of surgery. 14 patients received ECMO support postoperatively. Initial analysis of patients with head CTs show that patients who received ECMO had longer CPB and aortic cross-clamp times (p=0.015). They also had a shorter median ICU length of stay and increased mortality at discharge (p < 0.001). Patients in the ECMO group also had higher imaging scores consistent with more severe neurologic injuries (p=0.003). Additionally, for all patients, there was a positive correlation between postoperative head CT imaging scores and FSS (p=0.036).


Conclusions: CHD patients who require ECMO support post-CPB have worse outcomes, including head CT findings consistent with severe brain injury and higher mortality. There is a positive correlation between postoperative neuroimaging scores and FSS outcomes. More data and analysis is ongoing (including brain MRI imaging) to further investigate these findings.