Neurodevelopmental outcome in Hypoplastic left heart syndrome – impact of perioperative cerebral tissue oxygenation of the Norwood procedure

Objectives Patients with hypoplastic left heart syndrome are at risk for neurodevelopmental impairment. Hypoxic-ischemic brain injury during neonatal treatment might be a relevant cause. We evaluated the association between cerebral oxygenation in the perioperative course of the Norwood procedure and neurodevelopmental outcome. Methods Cerebral tissue oxygen saturation (ScO2) was obtained by near-infrared spectroscopy for 24 hours before and 48 hours after surgery in 43 patients. Full scale, verbal and performance IQ were evaluated with the Wechsler Preschool and Primary Scale of Intelligence at 4.5 (3.5-6.8) years. Cognitive functions were assessed with the German “Kognitiver Entwicklungstest für das Kindergartenalter” (KET-KID). Results IQ scores and KET-KID percentile ranks were in the lower normal range (Full scale IQ: 94 ±11, verbal IQ: 97 ±13, performance IQ: 93 ±9; KET-KID global: 42 ±27, verbal: 48 ±29, nonverbal: 37 ±23). Scores were below average (Full scale IQ