Neurodevelopmental Outcomes After Open Heart Operations Before 3 Months of Age
Background The purpose of this study was to monitor developmental progress and identify predictors of developmental outcomes at 2 years after operation in infants who underwent a surgical procedure with cardiopulmonary bypass (CPB) at less than 3 months of age. Methods Patients (N = 131 enrolled; N...
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| Veröffentlicht in: | The Annals of thoracic surgery 2012-05, Vol.93 (5), p.1577-1583 |
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| creator | Sananes, Renée, PhD Manlhiot, Cedric, BS Kelly, Edmond, MD Hornberger, Lisa K., MD Williams, William G., MD MacGregor, Daune, MD Buncic, Raymond, MD McCrindle, Brian W., MD, MPH |
| description | Background The purpose of this study was to monitor developmental progress and identify predictors of developmental outcomes at 2 years after operation in infants who underwent a surgical procedure with cardiopulmonary bypass (CPB) at less than 3 months of age. Methods Patients (N = 131 enrolled; N = 106 assessed) less than 3 months of age at the time of cardiac operation were prospectively enrolled (years 1999–2003) and assessed at 8, 12, and 24 months after operation. Patients with preexisting conditions independently associated with poor neurodevelopmental outcomes were excluded. Fine and gross motor development was formally assessed at all 3 visits, and parent ratings of development across several domains were obtained. Neurodevelopment was formally assessed at 24 months of age using the Bayley Scales of Infant Development, 2nd edition (BSID-II) Mental Development Index score (MDI). Results Significant gross motor difficulties were identified at 8 months of age ( p < 0.001) and, although improved by the 24-month assessment, remained lower than average. Fine motor skills showed a significant decrease from 8 to 24 months of age ( p = 0.001). Factors associated with poorer neurodevelopmental outcome (BSID-II MDI) at 24 months after operation included a diagnosis of univentricular anatomy or complex coarctation of the aorta, higher complexity of the surgical procedure, longer duration of hospital stay, and presence of complications in the postoperative period. Conclusions Children undergoing repair of congenital heart disease (CHD) still have impaired development 2 years after the operation. Observed patterns of development were specific to the skill being assessed and related to both anatomic complexity and increased complexity of care received. |
| doi_str_mv | 10.1016/j.athoracsur.2012.02.011 |
| format | Article |
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Methods Patients (N = 131 enrolled; N = 106 assessed) less than 3 months of age at the time of cardiac operation were prospectively enrolled (years 1999–2003) and assessed at 8, 12, and 24 months after operation. Patients with preexisting conditions independently associated with poor neurodevelopmental outcomes were excluded. Fine and gross motor development was formally assessed at all 3 visits, and parent ratings of development across several domains were obtained. Neurodevelopment was formally assessed at 24 months of age using the Bayley Scales of Infant Development, 2nd edition (BSID-II) Mental Development Index score (MDI). Results Significant gross motor difficulties were identified at 8 months of age ( p < 0.001) and, although improved by the 24-month assessment, remained lower than average. Fine motor skills showed a significant decrease from 8 to 24 months of age ( p = 0.001). Factors associated with poorer neurodevelopmental outcome (BSID-II MDI) at 24 months after operation included a diagnosis of univentricular anatomy or complex coarctation of the aorta, higher complexity of the surgical procedure, longer duration of hospital stay, and presence of complications in the postoperative period. Conclusions Children undergoing repair of congenital heart disease (CHD) still have impaired development 2 years after the operation. Observed patterns of development were specific to the skill being assessed and related to both anatomic complexity and increased complexity of care received.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/j.athoracsur.2012.02.011</identifier><identifier>PMID: 22541188</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age ; Age Factors ; Analysis of Variance ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Aorta ; Biological and medical sciences ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - methods ; Cardiology. Vascular system ; Cardiopulmonary Bypass - adverse effects ; Cardiopulmonary Bypass - methods ; Cardiothoracic Surgery ; Child Development - physiology ; Children ; Cohort Studies ; Developmental Disabilities - epidemiology ; Developmental Disabilities - etiology ; Developmental Disabilities - physiopathology ; Female ; Follow-Up Studies ; Heart ; Heart Defects, Congenital - diagnosis ; Heart Defects, Congenital - mortality ; Heart Defects, Congenital - surgery ; Heart diseases ; Hospitals ; Hospitals, Pediatric ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infants ; Intellectual Disability - epidemiology ; Intellectual Disability - etiology ; Intellectual Disability - physiopathology ; Linear Models ; Logistic Models ; Male ; Medical sciences ; Mental development ; Motor skill ; Motor Skills Disorders - epidemiology ; Motor Skills Disorders - etiology ; Motor Skills Disorders - physiopathology ; Neuropsychological Tests ; Ontario ; Pneumology ; Postoperative Complications - epidemiology ; Postoperative Complications - physiopathology ; Retrospective Studies ; Risk Assessment ; Surgery ; Survival Rate ; Thorax ; Time Factors ; Treatment Outcome</subject><ispartof>The Annals of thoracic surgery, 2012-05, Vol.93 (5), p.1577-1583</ispartof><rights>The Society of Thoracic Surgeons</rights><rights>2012 The Society of Thoracic Surgeons</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-51f274088a4bb889c27e644ef745581cc2fc6678e5319754e026f926b7a944123</citedby><cites>FETCH-LOGICAL-c492t-51f274088a4bb889c27e644ef745581cc2fc6678e5319754e026f926b7a944123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25863282$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22541188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sananes, Renée, PhD</creatorcontrib><creatorcontrib>Manlhiot, Cedric, BS</creatorcontrib><creatorcontrib>Kelly, Edmond, MD</creatorcontrib><creatorcontrib>Hornberger, Lisa K., MD</creatorcontrib><creatorcontrib>Williams, William G., MD</creatorcontrib><creatorcontrib>MacGregor, Daune, MD</creatorcontrib><creatorcontrib>Buncic, Raymond, MD</creatorcontrib><creatorcontrib>McCrindle, Brian W., MD, MPH</creatorcontrib><title>Neurodevelopmental Outcomes After Open Heart Operations Before 3 Months of Age</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background The purpose of this study was to monitor developmental progress and identify predictors of developmental outcomes at 2 years after operation in infants who underwent a surgical procedure with cardiopulmonary bypass (CPB) at less than 3 months of age. Methods Patients (N = 131 enrolled; N = 106 assessed) less than 3 months of age at the time of cardiac operation were prospectively enrolled (years 1999–2003) and assessed at 8, 12, and 24 months after operation. Patients with preexisting conditions independently associated with poor neurodevelopmental outcomes were excluded. Fine and gross motor development was formally assessed at all 3 visits, and parent ratings of development across several domains were obtained. Neurodevelopment was formally assessed at 24 months of age using the Bayley Scales of Infant Development, 2nd edition (BSID-II) Mental Development Index score (MDI). Results Significant gross motor difficulties were identified at 8 months of age ( p < 0.001) and, although improved by the 24-month assessment, remained lower than average. Fine motor skills showed a significant decrease from 8 to 24 months of age ( p = 0.001). Factors associated with poorer neurodevelopmental outcome (BSID-II MDI) at 24 months after operation included a diagnosis of univentricular anatomy or complex coarctation of the aorta, higher complexity of the surgical procedure, longer duration of hospital stay, and presence of complications in the postoperative period. Conclusions Children undergoing repair of congenital heart disease (CHD) still have impaired development 2 years after the operation. Observed patterns of development were specific to the skill being assessed and related to both anatomic complexity and increased complexity of care received.</description><subject>Age</subject><subject>Age Factors</subject><subject>Analysis of Variance</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Aorta</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Cardiology. Vascular system</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Cardiopulmonary Bypass - methods</subject><subject>Cardiothoracic Surgery</subject><subject>Child Development - physiology</subject><subject>Children</subject><subject>Cohort Studies</subject><subject>Developmental Disabilities - epidemiology</subject><subject>Developmental Disabilities - etiology</subject><subject>Developmental Disabilities - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart Defects, Congenital - diagnosis</subject><subject>Heart Defects, Congenital - mortality</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart diseases</subject><subject>Hospitals</subject><subject>Hospitals, Pediatric</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Intellectual Disability - epidemiology</subject><subject>Intellectual Disability - etiology</subject><subject>Intellectual Disability - physiopathology</subject><subject>Linear Models</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental development</subject><subject>Motor skill</subject><subject>Motor Skills Disorders - epidemiology</subject><subject>Motor Skills Disorders - etiology</subject><subject>Motor Skills Disorders - physiopathology</subject><subject>Neuropsychological Tests</subject><subject>Ontario</subject><subject>Pneumology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Thorax</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNklFvFCEQx4nR2LP6FQwvJr7sCbPAsi8m16Zak9p7UJ8Jxw2Wc285gW3Sby-bO23iiyaTAOE38x_-DCGUsyVnXL3bLW25i8m6PKUlMA5LVoPzJ2TBpYRGgeyfkgVjrG1E38kz8iLnXT1CvX5OzgCk4FzrBbm9xSnFLd7jEA97HIsd6HoqLu4x05UvmOj6gCO9RpvKvE22hDhmeoE-JqQt_RzHcpdp9HT1HV-SZ94OGV-d1nPy7cPV18vr5mb98dPl6qZxoofSSO6hE0xrKzYbrXsHHSoh0HdCSs2dA--U6jTKltf2BTJQvge16WwvBIf2nLw91j2k-HPCXMw-ZIfDYEeMUzYcOlC9ruy_UcaZ0CBZW1F9RF2KOSf05pDC3qaHCs2cMjvzaLyZjTesBp9VXp9Ups0et38SfztdgTcnwGZnB5_s6EJ-5KRWLej5ZRdHDqt99wGTyS7g6HAbErpitjH8Tzfv_yrihjCGqvsDHzDv4pTG-j2Gm1wTzJd5UOY54VBHpJOy_QXwcri1</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Sananes, Renée, PhD</creator><creator>Manlhiot, Cedric, BS</creator><creator>Kelly, Edmond, MD</creator><creator>Hornberger, Lisa K., MD</creator><creator>Williams, William G., MD</creator><creator>MacGregor, Daune, MD</creator><creator>Buncic, Raymond, MD</creator><creator>McCrindle, Brian W., MD, MPH</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20120501</creationdate><title>Neurodevelopmental Outcomes After Open Heart Operations Before 3 Months of Age</title><author>Sananes, Renée, PhD ; Manlhiot, Cedric, BS ; Kelly, Edmond, MD ; Hornberger, Lisa K., MD ; Williams, William G., MD ; MacGregor, Daune, MD ; Buncic, Raymond, MD ; McCrindle, Brian W., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-51f274088a4bb889c27e644ef745581cc2fc6678e5319754e026f926b7a944123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Age Factors</topic><topic>Analysis of Variance</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Aorta</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Cardiology. Vascular system</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Cardiopulmonary Bypass - methods</topic><topic>Cardiothoracic Surgery</topic><topic>Child Development - physiology</topic><topic>Children</topic><topic>Cohort Studies</topic><topic>Developmental Disabilities - epidemiology</topic><topic>Developmental Disabilities - etiology</topic><topic>Developmental Disabilities - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart Defects, Congenital - diagnosis</topic><topic>Heart Defects, Congenital - mortality</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Heart diseases</topic><topic>Hospitals</topic><topic>Hospitals, Pediatric</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Intellectual Disability - epidemiology</topic><topic>Intellectual Disability - etiology</topic><topic>Intellectual Disability - physiopathology</topic><topic>Linear Models</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental development</topic><topic>Motor skill</topic><topic>Motor Skills Disorders - epidemiology</topic><topic>Motor Skills Disorders - etiology</topic><topic>Motor Skills Disorders - physiopathology</topic><topic>Neuropsychological Tests</topic><topic>Ontario</topic><topic>Pneumology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Thorax</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sananes, Renée, PhD</creatorcontrib><creatorcontrib>Manlhiot, Cedric, BS</creatorcontrib><creatorcontrib>Kelly, Edmond, MD</creatorcontrib><creatorcontrib>Hornberger, Lisa K., MD</creatorcontrib><creatorcontrib>Williams, William G., MD</creatorcontrib><creatorcontrib>MacGregor, Daune, MD</creatorcontrib><creatorcontrib>Buncic, Raymond, MD</creatorcontrib><creatorcontrib>McCrindle, Brian W., MD, MPH</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sananes, Renée, PhD</au><au>Manlhiot, Cedric, BS</au><au>Kelly, Edmond, MD</au><au>Hornberger, Lisa K., MD</au><au>Williams, William G., MD</au><au>MacGregor, Daune, MD</au><au>Buncic, Raymond, MD</au><au>McCrindle, Brian W., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neurodevelopmental Outcomes After Open Heart Operations Before 3 Months of Age</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>93</volume><issue>5</issue><spage>1577</spage><epage>1583</epage><pages>1577-1583</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background The purpose of this study was to monitor developmental progress and identify predictors of developmental outcomes at 2 years after operation in infants who underwent a surgical procedure with cardiopulmonary bypass (CPB) at less than 3 months of age. Methods Patients (N = 131 enrolled; N = 106 assessed) less than 3 months of age at the time of cardiac operation were prospectively enrolled (years 1999–2003) and assessed at 8, 12, and 24 months after operation. Patients with preexisting conditions independently associated with poor neurodevelopmental outcomes were excluded. Fine and gross motor development was formally assessed at all 3 visits, and parent ratings of development across several domains were obtained. Neurodevelopment was formally assessed at 24 months of age using the Bayley Scales of Infant Development, 2nd edition (BSID-II) Mental Development Index score (MDI). Results Significant gross motor difficulties were identified at 8 months of age ( p < 0.001) and, although improved by the 24-month assessment, remained lower than average. Fine motor skills showed a significant decrease from 8 to 24 months of age ( p = 0.001). Factors associated with poorer neurodevelopmental outcome (BSID-II MDI) at 24 months after operation included a diagnosis of univentricular anatomy or complex coarctation of the aorta, higher complexity of the surgical procedure, longer duration of hospital stay, and presence of complications in the postoperative period. Conclusions Children undergoing repair of congenital heart disease (CHD) still have impaired development 2 years after the operation. Observed patterns of development were specific to the skill being assessed and related to both anatomic complexity and increased complexity of care received.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22541188</pmid><doi>10.1016/j.athoracsur.2012.02.011</doi><tpages>7</tpages></addata></record> |
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| subjects | Age Age Factors Analysis of Variance Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Aorta Biological and medical sciences Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - methods Cardiology. Vascular system Cardiopulmonary Bypass - adverse effects Cardiopulmonary Bypass - methods Cardiothoracic Surgery Child Development - physiology Children Cohort Studies Developmental Disabilities - epidemiology Developmental Disabilities - etiology Developmental Disabilities - physiopathology Female Follow-Up Studies Heart Heart Defects, Congenital - diagnosis Heart Defects, Congenital - mortality Heart Defects, Congenital - surgery Heart diseases Hospitals Hospitals, Pediatric Humans Incidence Infant Infant, Newborn Infants Intellectual Disability - epidemiology Intellectual Disability - etiology Intellectual Disability - physiopathology Linear Models Logistic Models Male Medical sciences Mental development Motor skill Motor Skills Disorders - epidemiology Motor Skills Disorders - etiology Motor Skills Disorders - physiopathology Neuropsychological Tests Ontario Pneumology Postoperative Complications - epidemiology Postoperative Complications - physiopathology Retrospective Studies Risk Assessment Surgery Survival Rate Thorax Time Factors Treatment Outcome |
| title | Neurodevelopmental Outcomes After Open Heart Operations Before 3 Months of Age |
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