Over the past decade, new research has advanced scientific knowledge of neurodevelopmental trajectories, factors that increase neurodevelopmental risk, and neuroprotective strategies for individuals with congenital heart disease. In addition, best practices for evaluation and management of developmental delays and disorders in this high-risk patient population have been formulated based on literature review and expert consensus. This American Heart Association scientific statement serves as an update to the 2012 statement on the evaluation and management of neurodevelopmental outcomes in children with congenital heart disease. It includes revised risk categories for developmental delay or disorder and an updated list of factors that increase neurodevelopmental risk in individuals with congenital heart disease according to current evidence, including genetic predisposition, fetal and perinatal factors, surgical and perioperative factors, socioeconomic disadvantage, and parental psychological distress. It also includes an updated algorithm for referral, evaluation, and management of individuals at high risk. Risk stratification of individuals with congenital heart disease with the updated categories and risk factors will identify a large and growing population of survivors at high risk for developmental delay or disorder and associated impacts across the life span. Critical next steps must include efforts to prevent and mitigate developmental delays and disorders. The goal of this scientific statement is to inform health care professionals caring for patients with congenital heart disease and other key stakeholders about the current state of knowledge of neurodevelopmental outcomes for individuals with congenital heart disease and best practices for neuroprotection, risk stratification, evaluation, and management.

中文翻译：

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先天性心脏病患者的神经发育结果：神经保护、风险分层、评估和管理的最新进展：美国心脏协会的科学声明

在过去的十年中，新的研究推进了关于神经发育轨迹、增加神经发育风险的因素以及先天性心脏病患者的神经保护策略的科学知识。此外，根据文献综述和专家共识，制定了评估和管理这一高危患者群体发育迟缓和障碍的最佳实践。美国心脏协会的这份科学声明是 2012 年关于先天性心脏病儿童神经发育结果评估和管理声明的更新。它包括修订后的发育迟缓或发育障碍的风险类别，以及根据现有证据增加先天性心脏病个体神经发育风险的最新因素列表，包括遗传易感性、胎儿和围产期因素、手术和围手术期因素、社会经济劣势以及父母的影响。心理困扰。它还包括用于高风险个人转介、评估和管理的更新算法。根据更新的类别和风险因素对先天性心脏病患者进行风险分层，将识别出大量且不断增长的幸存者，这些幸存者在整个生命周期中处于发育迟缓或障碍以及相关影响的高风险。接下来的关键步骤必须包括努力预防和减轻发育迟缓和障碍。本科学声明的目的是让护理先天性心脏病患者的医疗保健专业人员和其他主要利益相关者了解先天性心脏病患者神经发育结果的当前知识状况以及神经保护、风险分层、评估和治疗的最佳实践。管理。