Neuropsychological outcome of infant heart transplant recipients

Baum, Marti; Freier, M. Catherin; Freeman, Kim; Babikian, Talin; Ashwal, Stephen; Chinnock, Richard; Bailey, Leonard L.

doi:10.1016/j.jpeds.2004.05.047

Cited by 34 publications

(40 citation statements)

References 28 publications

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“…For patients who were Ͻ36 months of age, the median Mental Developmental Index score was 88 and the median Psychomotor Developmental Index score was 86.5. More recently, Baum et al 3 reported the neurologic outcomes for 55 school-aged patients (Ͼ5 years of age) who had undergone infant heart transplantation, the majority (75%) of whom had HLHS. The mean full-scale IQ score in that series was 81 Ϯ 19, below expected population normative values.…”

Section: Discussionmentioning

confidence: 99%

“…A number of other investigators have identified prominent deficits in visual-motor and visual-spatial domains among children with HLHS and other congenital heart lesions. 3,7,14 An association between the use of DHCA and visual-spatial deficits was reported for children with transposition of the great arteries. 14 A variety of patient-and procedure-related factors for neurodevelopmental delay have been identified in the HLHS population.…”

Section: Discussionmentioning

confidence: 99%

“…Previous investigators found an association between length of hospital stay and neurodevelopmental outcomes. 3,16,17 Examining children with transposition of the great arteries who underwent arterial switch and were evaluated subsequently at 8 years of age, Newburger et al 16 reported that each additional 1 day of hospital stay led to a reduction of 0.9 points in full-scale IQ scores. Similarly, Limperopoulos et al 18 demonstrated that longer durations of hospital stay were associated with lower scores on the Griffiths Mental Developmental Scale and a higher prevalence of neurologic abnormalities in a cohort of infants with a variety of congenital heart lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, singlecenter series have reported mild to moderate cognitive deficits. [3][4][5][6][7] Recent data suggested that a variety of factors related to cardiovascular anatomic features and prenatal hemodynamics might play important roles in neurodevelopmental outcomes for these patients. 8,9 It is not known, however, whether one surgical strategy, ie, transplantation or the Norwood procedure, might result in more favorable outcomes.…”

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confidence: 99%

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Relationship of Surgical Approach to Neurodevelopmental Outcomes in Hypoplastic Left Heart Syndrome

Visconti²,

et al. 2006

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OBJECTIVE. Two strategies for surgical management are used for infants with hypoplastic left heart syndrome (HLHS), primary heart transplantation and the Norwood procedure. We sought to determine how these 2 surgical approaches influence neurodevelopmental outcomes at school age. METHODS. A multicenter, cross-sectional study of neurodevelopmental outcomes among school-aged children (>8 years of age) with HLHS was undertaken between July 2003 and September 2004. Four centers enrolled 48 subjects, of whom 47 completed neuropsychologic testing. Twenty-six subjects (55%) had undergone the Norwood procedure and 21 (45%) had undergone transplantation, with an intention-to-treat analysis. The mean age at testing was 12.4 ± 2.5 years. Evaluations included the Wechsler Abbreviated Scale of Intelligence, Clinical Evaluation of Language Fundamentals, Wechsler Individual Achievement Test, and Beery-Buktenica Developmental Test of Visual-Motor Integration. RESULTS. The mean neurocognitive test results were significantly below population normative values. The mean full-scale IQ for the entire cohort was 86 ± 14. In a multivariate model, there was no association of surgical strategy with any measure of developmental outcome. A longer hospital stay, however, was associated significantly with lower verbal, performance, and full-scale IQ scores. Aortic valve atresia was associated with lower math achievement test scores. CONCLUSIONS. Neurodevelopmental deficits are prevalent among school-aged children with HLHS, regardless of surgical approach. Complications that result in prolonged hospitalization at the time of the initial operation are associated with neurodevelopmental status at school age.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Relationship of Surgical Approach to Neurodevelopmental Outcomes in Hypoplastic Left Heart Syndrome

Visconti²,

et al. 2006

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“…18 More recent reports from single-center and multicenter studies have verified this pattern, that children who received heart transplants generally perform at about a 10-to 15-point deficit compared with nonclinical comparison populations. 16,19,20 Predictors of poorer cognitive function have included birth head circumference, prolonged stay after transplantation, and pre-transplant diagnosis of congenital heart disease (as opposed to cardiomyopathy). The report by Ikle et al 16 noted a correlation between waiting time to transplant and ultimate intelligence quotient (IQ) scores in a small sample of infants with HLHS, with a 4.5 IQ point decrease for each month waiting for surgery.…”

Section: Cognitive Abilitymentioning

confidence: 99%