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 .
Neurodevelopmental outcomes after regional cerebral perfusion with neuromonitoring for neonatal aortic arch reconstruction.
BACKGROUND In this study we report magnetic resonance imaging ( MRI ) brain injury and 12-month neurodevelopmental outcomes when regional cerebral perfusion ( RCP ) is used for neonatal aortic arch reconstruction . METHODS Fifty-seven neonates receiving RCP during aortic arch reconstruction were enrolled in a prospect i ve outcome study . RCP flows were determined by near-infrared spectroscopy and transcranial Doppler monitoring . Brain MRI was performed preoperatively and 7 days postoperatively . Bayley Scales of Infant Development III was performed at 12 months . RESULTS Mean RCP time was 71 ± 28 minutes ( range , 5 to 121 minutes ) and mean flow was 56.6 ± 10.6 mL/kg/min . New postoperative MRI brain injury was seen in 40 % of patients . For 35 RCP patients at age 12 months , mean Bayley Scales III Composite st and ard scores were : Cognitive , 100.1 ± 14.6 ( range , 75 to 125 ) ; Language , 87.2 ± 15.0 ( range , 62 to 132 ) ; and Motor , 87.9 ± 16.8 ( range , 58 to 121 ) . Increasing duration of RCP was not associated with adverse neurodevelopmental outcomes . CONCLUSIONS Neonatal aortic arch repair with RCP using a neuromonitoring strategy results in 12-month cognitive outcomes that are at reference population norms . Language and motor outcomes are lower than the reference population norms by 0.8 to 0.9 st and ard deviations . The neurodevelopmental outcomes in this RCP cohort demonstrate that this technique is effective and safe in supporting the brain during neonatal aortic arch reconstruction
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 .