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Neurodevelopmental Outcomes of Infants after Neonatal Surgical Intervention for Tetralogy of Fallot or Pulmonary Atresia.
Leclair, Guillaume; Dingankar, Adil; Robertson, Charlene M T; Bond, Gwen Y; Mohammadian, Parsa; Dinu, Irina; Averin, Konstantin; Guerra, Gonzalo Garcia; Atallah, Joseph.
Afiliación
  • Leclair G; Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada. Electronic address: guillaume.leclair@mail.mcgill.ca.
  • Dingankar A; Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada.
  • Robertson CMT; Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada; Complex Pediatric Therapies Follow-up Program, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.
  • Bond GY; Complex Pediatric Therapies Follow-up Program, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.
  • Mohammadian P; Institute of Biostatistics and Registry Research, Brandenburg Medical School, Neuruppin, Germany.
  • Dinu I; School of Public Health, University of Alberta, Edmonton, AB, Canada.
  • Averin K; Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada.
  • Guerra GG; Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada.
  • Atallah J; Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada.
J Pediatr ; 262: 113640, 2023 11.
Article en En | MEDLINE | ID: mdl-37517650
OBJECTIVE: To determine the 2-year neurodevelopmental outcomes for survivors of neonatal cardiac surgery for the most common right ventricular outflow tract obstructive lesions: tetralogy of Fallot and pulmonary atresia with a ventricular septal defect. STUDY DESIGN: A single-center consecutive cohort of 77 children underwent neonatal surgery for tetralogy of Fallot or pulmonary atresia with a ventricular septal defect at ≤6 weeks of age between 2006 and 2017. The patients underwent a multidisciplinary neurodevelopmental assessment at 18-24 months of age. Survivor outcomes were compared by univariable and multivariable analyses. RESULTS: The 2-year mortality was 7.8% (6/77) with a postoperative in-hospital mortality of 3.9% (3/77). Freedom from reintervention by cardiac catheterization or surgical intervention at 2 years was 36%. Functional and neurodevelopmental assessment for 69 of 71 survivors was completed at a mean age of 22.6 ± 4.0 months using the Bayley Scales of Infant and Toddler Development III. The mean neurodevelopmental outcome scores were 83.4 ± 16.5 for cognitive skills, 82.2 ± 18.7 for language skills, and 81.4 ± 18.1 for motor skills. Cognitive, language, and motor delay, defined as a score of <70, was identified in 25%, 25%, and 23% of patients, respectively. Multivariable analyses for factors associated with worse neurodevelopmental outcomes identified chromosomal anomalies (P < .001) and postoperative complications (P < .03). CONCLUSIONS: Cyanotic tetralogy of Fallot and pulmonary atresia with ventricular septal defect requiring neonatal repair showed similar 2-year neurodevelopmental outcomes below normative values and a high prevalence of cognitive, language and motor delays.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tetralogía de Fallot / Atresia Pulmonar / Cardiopatías Congénitas / Defectos del Tabique Interventricular / Procedimientos Quirúrgicos Cardíacos Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child, preschool / Humans / Infant / Newborn Idioma: En Revista: J Pediatr Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tetralogía de Fallot / Atresia Pulmonar / Cardiopatías Congénitas / Defectos del Tabique Interventricular / Procedimientos Quirúrgicos Cardíacos Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child, preschool / Humans / Infant / Newborn Idioma: En Revista: J Pediatr Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos