A Closer Look at Neurodevelopmental Outcomes in Children With Congenital Heart Disease

Children with congenital heart disease have a higher risk of neurodevelopmental disabilities than the general population. With decades of data and the help of the Cardiac Neurodevelopmental Outcome Collaborative, Bradley Marino, MD, MPP, MSCE, MBA, Chair of Pediatric Cardiology at Cleveland Clinic Children’s hopes to improve neurodevelopmental and psychosocial outcomes – and overall quality of life – in this population.

White matter injury linked to adverse neurodevelopmental outcomes

Adverse neurodevelopmental and psychosocial outcomes in patients with congenital heart disease are still too common, and have been associated with a number of factors, including clinical comorbidities and approaches to medical and surgical treatment. Researching such outcomes and advocating for patients with congenital heart disease is a passion for Dr. Marino, an internationally recognized pediatric cardiovascular outcomes researcher who has recently assumed his leadership role at Cleveland Clinic Children’s.

“About 1 in 100 children will have congenital heart disease, and one-third of those children will require some sort of surgical or catheter-based intervention within the first 30 days of life,” Dr. Marino says. “Of those children that need interventions as newborns, about 50% will develop significant neurodevelopmental issues, including lower IQ, worse reading/math achievement, ADHD, poor executive functioning, slower processing speeds, worse working memory and fine motor skills. Psychosocially, many of these children suffer from anxiety, depression and chronic stress, as do their parents.”

According to Dr. Marino, patients who develop this phenotype may have sustained brain injuries during procedures to repair their hearts. Through collaboration with innovative surgical partners at Cleveland Clinic, Dr. Marino is working to establish robust neuro-protective protocols to minimize brain injury in both the operating room and pediatric cardiac intensive care unit.

About Dr. Marino

Dr. Marino earned his medical degree from Harvard Medical School and a Master’s degree in Public Policy from the John F. Kennedy School of Government at Harvard University. He completed his pediatric residency at Johns Hopkins Hospital and a combined fellowship in Pediatric Cardiology and Pediatric Critical Care Medicine at The Children’s Hospital of Philadelphia. While at the Perelman School of Medicine at the University of Pennsylvania, Dr. Marino completed a Master’s of Science degree in Clinical Epidemiology at the Center for Clinical Epidemiology and Biostatistics. He completed a Master’s degree in Business Administration in Healthcare Management at the University of Texas-Dallas Naveen Jindal School of Management.

Dr. Marino’s scientific work has been supported through more than two-dozen grants as a Principal Investigator or Co-Investigator from the National Institute of Health through NHLBI (RO1, R13, R34, R43, R44 SBIR, K23, UO1), NICHD (U24), the American Heart Association (AHA) (Strategically Focused Research Network for Children), the Children’s Heart Foundation, other national foundations and internal grants. He has published more than 170 peer-reviewed publications and written or edited more than a dozen books and 70 book chapters on pediatric cardiology and general pediatric medicine. He has been invited for 40 Visiting Professorships and given more than 160 international and national lectures based on his scientific inquiry.

Dr. Marino is an international leader and advocate for children with congenital and acquired heart disease. He has served as the AHA Chair of the Young Hearts Council, President of the AHA Chicago Metropolitan Board, inaugural Co-Chair for the international Cardiac Neurodevelopmental Outcome Collaborative, and the inaugural Chair of the Medical Advisory Board for Conquering Congenital Heart Disease. He has also served as a member of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery Executive Committee, Pediatric Cardiac Intensive Care Society Board of Directors, and Cardiac Networks United Steering Committee. He currently serves as a member of the AHA National Council Operations Committee and steering committee for the Congenital Heart Public Health Consortium. Dr. Marino has been awarded the Pediatric Congenital Heart Association Heart Hero Award, Cardiac Neurodevelopmental Outcome Collaborative Newburger-Bellinger Award, Congenital Heart Foundation Congenital Heart Defect Champion Award, and the Heart Institute Peter B. Manning Educational Award, and was elected to the Feinberg Academy of Medical Educators at the Northwestern University Feinberg School of Medicine.