Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation

Hövels-Gürich, Hedwig H.; Seghaye, Marie-Christine; Schnitker, Ralph; Wiesner, M; Huber, Walter; Minkenberg, Ralf; Kotlarek, F.; Messmer, Bruno J.; Bernuth, G. von

doi:10.1067/mtc.2002.122307

Cited by 170 publications

(157 citation statements)

References 33 publications

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“…Important situations such as socio-economic level, acidosis and pre-operative hypoxia as well as signs of low post-operative debt, all of which provide for a greater risk of significant future delays, were not assessed 6 .…”

Section: Statistical Analysis and Data Processingmentioning

confidence: 99%

“…some of the neurological findings that may be observed are seizures, alterations of consciousness, behavioral disorders, intellectual impairment, focal deficit, involuntary movements, and lesions to the periph-Neuropsychomotor development open-heart surgery in infants rocha et al eral nervous system. recent studies have assessed the influence of diverse circulatory bypass techniques on the neuropsychomotor development of newborns with transposition of the great arteries [1][2][3][4][5][6] . More recently, the repercussions of circulatory bypass and moderate hypothermia for the correction of common defects, such as septal defects and tetralogy of Fallot, have been studied [7][8][9][10] .…”

Section: Dra Taís Sica Da Rocha -Rua Farias Santos 500/301 -90670-15mentioning

confidence: 99%

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Neuropsychomotor development before and after open-heart surgery in infants

Rocha

Guardiola

Piva

et al. 2009

Arq. Neuro-Psiquiatr.

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-There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenthy infants had neurodevelopmental outcomes (neurological exam and Denver II test) assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%). The mean circulatory bypass time was 67±23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.Key WorDs: cardiac surgery, developmental delay, Denver II test.desenvolvimento neuropsicomotor de lactentes antes e após cirurgia cardíaca resumo -As alterações neurológicas em lactentes com cardiopatia congênita podem agravar seu quadro clínico e levar a seqüelas permanentes. Foi realizada uma coorte prospectiva, com 20 lactentes, com idade média de 6,7±4,2 meses, avaliando-se o perfil de desenvolvimento e o estado nutricional. Utilizou-se o exame neurológico e o teste de Denver II. os testes foram aplicados 24h antes da cirurgia, na alta da unidade de terapia intensiva e 3 a 6 meses após. os defeitos septais ocorreram em 11 casos (55%). o tempo médio de circulação extra-corpórea foi de 67±23,6 minutos. Quinze crianças tinham exame neurológico alterado e atraso no desenvolvimento neuropsicomotor antes da cirurgia, cuja normalização foi observada somente em seis após 6 meses .Quanto aos índices de Denver II, houve aumento em todos domínios, exceto o pessoalsocial. o escore Z médio para peso antes da cirurgia foi -2,814±1,98 e após -1,08±1,47 (p<0.05), o qual foi realizado em média 5.2±1.5 meses após a alta hospitalar. Melhora precoce tanto no desenvolvimento como no estado nutricional pôde ser observada neste grupo de lactentes após a correção cirúrgica.PAlAvrAs-cHAve: cirurgia cardíaca, atraso no desenvolvimento neurológico, teste de Denver II, cardiopatia congênita. corrective cardiac surgery involves a series of complex and high risk procedures and a large number of them expose the brain to hypoxic ischemic insults 1 . Prospective studies have shown that 100% of children who undergo cardiac surgery present with central nervous system dysfunctions in the immediate post-operative period 2 as a consequence of alterations in the cerebral blood flow. If the hypoxic ischemic insult is acute and extensive, the patients may not regain consciousness in the immediate post-operative period and stand increased chances of irreversible sequelae. some of the neurological findings that may be observed are seizures, alterations of consciousness, behavioral disorders, intellectual impairment, focal deficit, involuntary movements, and lesions to the periph-

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Section: Statistical Analysis and Data Processingmentioning

confidence: 99%

Section: Dra Taís Sica Da Rocha -Rua Farias Santos 500/301 -90670-15mentioning

confidence: 99%

Neuropsychomotor development before and after open-heart surgery in infants

Rocha

Guardiola

Piva

et al. 2009

Arq. Neuro-Psiquiatr.

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“…Severe preoperative hypoxia and acidosis have already been identified as predisposing factors to preoperative brain injury and motor delay in school-aged children with TGA (3,7).…”

mentioning

confidence: 99%

“…Although mortality is low, neonates with TGA are at risk of impaired neurodevelopmental outcome. Long-term follow-up demonstrates that 30-50% of school-aged children with TGA show some form of developmental delay, including fine and gross motor delay, impaired visuomotor integration, language and speech difficulties, and behavioral problems (2)(3)(4)(5).…”

mentioning

confidence: 99%

Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries

et al. 2012

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Background:The aim of this study was to determine the effect of balloon atrial septostomy (Bas) on cerebral oxygenation in neonates with transposition of the great arteries (TGa). Methods: In term neonates with TGa, regional cerebral tissue oxygen saturation (r c sO 2 ) was measured using near-infrared spectroscopy (NIRs) for a period of 2 h, before Bas, after Bas, and 24 h after Bas. In neonates who did not require Bas on clinical grounds, r c sO 2 was measured within 24 h of admission and 24 h later. results: Bas was performed in 12 of 21 neonates. r c sO 2 increased from a median of 42% (before) to 48% at 2 h after Bas (P < 0.05), as did transcutaneous arterial oxygen saturation (spO 2 ) (from 72% to 85%, P < 0.01). r c sO 2 increased further during the next 24 h (from 48% to 64%, P < 0.05), whereas spO 2 remained stable. although beginning from a lower baseline (42 vs. 51%, P < 0.01), r c sO 2 was higher in neonates treated with Bas, as compared with neonates not treated with Bas, 24 h after the procedure (64 vs. 58%, P < 0.05); spO 2 was, however, similar between the two groups. conclusion: Bas improves cerebral oxygen saturation in neonates with TGa. complete recovery of cerebral oxygen saturation occurred only 24 h after Bas.

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“…Evaluation of neurodevelopmental outcome of children with congenital heart disease requires long-term follow-up during school period and afterwards to understand the significance and depth of the problems. This subject was addressed in long-term studies performed in 60 pediatric patients who had undergone arterial switch operation (Jatene) because of transposition of the great arteries in different periods by the same study group (24,25). In the study performed in patients with ages ranging between 7.9 and 14.3 years, deficiencies were observed in areas of attention, motor and cognitive functions, academic success, language, speech, neurological development and even social functionality in 55% of the patients (24).…”

mentioning

confidence: 99%

Bebeklik döneminde siyanotik kalp hastalığı nedeniyle açık kalp cerrahisi uygulanmış ergenlerde kendilik algısı ve yaşam niteliği

Yıldız¹,

Zahmacioglu²,

Koca³

et al. 2011

tpa

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Aim:To assess the quality-of-life of the teenage patients who had undergone open heart surgery because of cyanotic heart disease during their infancy together with their parents and to compare their self-perception to that of the physically healthy control group. Material and Method:This study includes 53 patients who had undergone operation for cyanotic congenital heart disease in İstanbul University, Institute of Cardiology between 1989 and 1994. The relatives and the patients were informed with a consent form approved by İstanbul University, Cerrahpaşa Medical Faculty, Clinical Studies, Ethics Commitee (Decree no. D-005, Date: 11-10-2009). Group 1 was the healthy control group (15 patients, median age: 19 years 8 months), Group 2 included patients with single ventricle who had undergone Fontan procedure (20 patients, median age: 19 years 6 months; 10 of them had tricuspid atresia, 5 of them had pulmonary atresia with intact ventricular septum, 3 of them had double inlet left ventricle, 1 of them had double outlet right ventricle, 1 of them had ventricular septal defect and pulmonary atresia), group 3 included patients who had undergone operation for congenital cyanotic heart disease (33 patients, median age: 19 years 2 months; 18 of them had transposition of the great arteries, 10 of them had tetralogy of Fallot, 2 of them had complete atrioventricular canal defect and pulmonary stenosis, 2 of them had double outlet right ventricle, 1 of them had pentalogy of Fallot). In this study, the quality of life and self perception inventories were used. The quality of life inventory was completed by patients, healthy adolescents and their parents seperately. The self perception inventory was completed only by the patients and healthy adolescents. The comparison of age and self perception scores between the groups was carried out with unidirectional analysis of variance (ANOVA) and the multicomparisons with LSD (Least Significant Difference). Since the quality of life variable did not have a normal distribution, the comparions were carried out with Kruskal-Wallis nonparametric ANOVA test and the multicomparisons were carried out with Dunn's test. Results:There was not a significant difference between the groups in terms of age and sex. In the quality of life scale (QOLS), for the replies to related questions, a significant difference was determined between the groups. The replies of group 2 and 3 about quality of life of both the children and the parents were far more negative when compared to those of the control group. When the groups were compared via multiple comparison tests, there was no significant difference between group 2 and 3. The replies of the parents regarding their children's quality of life were statistically more negative than those of their children (p<0,001). Within the self perception scale, there were significant differences in terms of social acceptance, behaviours in relationships and general self perception (p=0.03, p=0.03 and p=0.01; repectively) between group 1 and 3. The most significant dif...

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Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation

Cited by 170 publications

References 33 publications

Neuropsychomotor development before and after open-heart surgery in infants

Neuropsychomotor development before and after open-heart surgery in infants

Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries

Bebeklik döneminde siyanotik kalp hastalığı nedeniyle açık kalp cerrahisi uygulanmış ergenlerde kendilik algısı ve yaşam niteliği

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