Organ system response to cardiac function-neurology

Mortality from surgery to correct congenital heart disease has improved, but high incidences of neurologic injuries and neurodevelopmental abnormalities persist. Neonates with critical heart disease have the highest risk of both neurologic injury and subsequent developmental abnormality. Congenital heart disease places the brain at risk from in utero development, through the perioperative period, and beyond. It has been a challenge of the collective congenital heart disease care team to identify modifiable elements contributing to this important morbidity. This chapter outlines relevant cerebral vascular physiology in the context of hemodynamic challenges posed by congenital heart disease before, during, and after surgical correction.