BACKGROUND: @entity1 with @entity299 are at increased risk of abnormal neurodevelopment (ND). Demographic and perioperative physiologic factors have both been associated with developmental outcome. The acute physiologic effect of a surgical procedure, anesthesia, and hospitalization may offset any potential advantage gained from anatomic correction and circulatory palliation. The specific risk/benefit balance on ND outcome of the insult of the operation, offset by the benefit of improved anatomy and physiology, has not been addressed. We therefore sought to identify interval procedural and physiologic factors assessed at outpatient ND evaluation visits that were associated with outcome. METHODS: The study included @entity1 with @entity299 at high risk for impaired ND performance with at least three ND assessments using the Bayley Scales of @entity1 Development-III during the first 3 years of life. The number of cardiac procedures, duration of hospitalization, feeding status, height, weight, and arterial, cerebral, and somatic @entity26 saturations by near-infrared spectroscopy were recorded at each visit and used as predictors of language, motor, and cognitive composite scores and slopes (change over time) in general linear models. RESULTS: Data on 178 @entity1 derived from 632 visits (median, 4 visits/ @entity1 ) were analyzed, with ages at first  and last assessment of 7.7 and 30.2 months. Fifty-one had 1 ventricle (1V), 88 had 2 ventricles, and 39 had @entity74 conditions. Motor performance increased with age in all diagnostic categories. Cognitive and language performance increased with age in 1V @entity1 but exhibited no significant change in 2-ventricle and @entity74 groups. At the first visit, 1V @entity1 performed less well than 2-ventricle @entity1 in the motor domain, but the rate of improvement was higher for 1V @entity1 ; by 24 months, there were no differences, and both groups were normal in all domains. Performance in @entity74 @entity1 was below normal in all domains at the first visit and did not improve. Higher arterial saturation and narrower arterial-cerebral and arterial-somatic near-infrared spectroscopy saturation differences were associated with better or improving motor performance. Incremental cardiopulmonary bypass time, cumulative hospital length of stay, and tube feedings were risk factors in all domains. Total and incremental times for deep hypothermic @entity1167 , extracorporeal membrane oxygenation, total open and total surgical procedures, and birth weight were not risk factors. CONCLUSIONS: @entity1 physiologic status assessed by cerebral and somatic near-infrared spectroscopy is associated with ND performance. Incremental surgical procedures are not associated with ND performance when adjusted for cardiopulmonary bypass time and physiologic status. Treatment strategies that target improved physiologic status may also improve ND outcome.

Effect of Intercurrent Operation and Cerebral Oxygenation on Developmental Trajectory in XXXX .

@entity1 :: ('9606', 'Species') :: ['child', 'children', 'Infant', 'patients', 'Children', 'Patient'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity299 :: ('MESH:D006331', 'Disease') :: ['congenital heart disease'] @entity74 :: ('MESH:D030342', 'Disease') :: ['genetic syndrome'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['circulatory arrest']
@entity299 :: (MESH:D006331,Disease) :: ['Congenital Heart Disease']
