Cardiac Structure in Pediatric Patients at Ages 2 and 10 Following Repair of Congenital Diaphragmatic Hernia: A Comparative MRI Study of ECMO and Non-ECMO Cases

By
Schanas Jawhar
Greta Thater
Stefan Appelhaus
Michael Boettcher
Julia Elrod
Frank G. Zoellner
Florian Kipfmueller
Marcia Matos-Karaorman
Stefan O. Schoenberg
Meike Weis
September 9, 2026

European Radiology

Overview

This study investigates long-term cardiac alterations in pediatric patients with congenital diaphragmatic hernia (CDH) who underwent repair, comparing those who required extracorporeal membrane oxygenation (ECMO) with those who did not. MRI-derived parameters were evaluated at ages 2 and 10 to assess cardiac morphology and function.

Background

Congenital diaphragmatic hernia (CDH) is a significant congenital anomaly that can lead to severe pulmonary complications and long-term morbidity. Advances in treatment have improved survival rates, but many patients experience ongoing cardiopulmonary issues, particularly those who required ECMO.

Data Highlights

Parameter	ECMO Group (n=31)	Non-ECMO Group (n=26)
PA/Ao Ratio	Data not provided	Data not provided
RV/LV Ratio	Data not provided	Data not provided
Eccentricity Index	Data not provided	Data not provided

Key Findings

CDH affects approximately 1 in 2000–5000 live births.
PAH is a significant determinant of outcomes in CDH patients.
Patients requiring ECMO face a higher risk of long-term complications.
Postnatal ventricular disproportion is linked to increased mortality and ECMO requirement.
The study utilized MRI to assess cardiac morphology and function at ages 2 and 10.

Clinical Implications

The findings highlight the need for ongoing cardiopulmonary surveillance in CDH patients, particularly those who required ECMO. Clinicians should consider the long-term cardiac assessments as part of the follow-up care for these patients.

Conclusion

This study underscores the importance of understanding cardiac changes in pediatric CDH patients, particularly in those who underwent ECMO, to inform long-term management strategies.