Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .
Adolescents With d-Transposition of the Great Arteries Corrected With the Arterial Switch Procedure: Neuropsychological Assessment and Structural Brain Imaging
Background — We report neuropsychological and structural brain imaging assessment s in children 16 years of age with d-transposition of the great arteries who underwent the arterial switch operation as infants . Children were r and omly assigned to a vital organ support method , deep hypothermia with either total circulatory arrest or continuous low-flow cardiopulmonary bypass . Methods and Results — Of 159 eligible adolescents , 139 ( 87 % ) participated .  Academic achievement , memory , executive functions , visual-spatial skills , attention , and social cognition were assessed . Few significant treatment group differences were found . The occurrence of seizures in the postoperative period was the medical variable most consistently related to worse outcomes . The scores of both treatment groups tended to be lower than those of the test normative population s , with substantial proportions scoring ≥1 SDs below the expected mean . Although the test scores of most adolescents in this trial cohort are in the average range , a substantial proportion have received remedial academic or behavioral services ( 65 % ) . Magnetic resonance imaging abnormalities were more frequent in the d-transposition of the great arteries group ( 33 % ) than in a referent group ( 4 % ) . Conclusions — Adolescents with d-transposition of the great arteries who have undergone the arterial switch operation are at increased neurodevelopmental risk . These data suggest that children with congenital heart disease may benefit from ongoing surveillance to identify emerging difficulties . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT00000470
Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .