Functional, quality of life, and neurodevelopmental outcomes after congenital cardiac surgery
Abstract Throughout the past few decades, advances in cardiology, neonatal intensive care, and surgical techniques have resulted in a growing cohort of thriving school-aged children with previously lethal complex congenital heart diseases. While survival has increased, there remains significant morb...
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Veröffentlicht in: | Seminars in perinatology 2016-12, Vol.40 (8), p.556-570 |
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description | Abstract Throughout the past few decades, advances in cardiology, neonatal intensive care, and surgical techniques have resulted in a growing cohort of thriving school-aged children with previously lethal complex congenital heart diseases. While survival has increased, there remains significant morbidity following repair including neurodevelopmental sequelae. Compared to children with a structurally normal heart, these infants and children have a higher frequency of abnormalities in tone, feeding, and delayed developmental milestones, as well as challenges with speech and learning disabilities, while a higher proportion of adolescents suffer from problems with processing speed, executive function, and a unique set of medical hardships related to exercise intolerance and obesity, medication burden, and mental health comorbidities. Innovative perioperative techniques and early psychosocial intervention in these young survivors has shown that despite the obstacles, the majority of these children can grow to have fulfilling lives with intelligence and social skills in the normal range. Additionally, a comprehensive medical home aids in optimizing the quality of life for these children and their families. |
doi_str_mv | 10.1053/j.semperi.2016.09.008 |
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While survival has increased, there remains significant morbidity following repair including neurodevelopmental sequelae. Compared to children with a structurally normal heart, these infants and children have a higher frequency of abnormalities in tone, feeding, and delayed developmental milestones, as well as challenges with speech and learning disabilities, while a higher proportion of adolescents suffer from problems with processing speed, executive function, and a unique set of medical hardships related to exercise intolerance and obesity, medication burden, and mental health comorbidities. Innovative perioperative techniques and early psychosocial intervention in these young survivors has shown that despite the obstacles, the majority of these children can grow to have fulfilling lives with intelligence and social skills in the normal range. 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While survival has increased, there remains significant morbidity following repair including neurodevelopmental sequelae. Compared to children with a structurally normal heart, these infants and children have a higher frequency of abnormalities in tone, feeding, and delayed developmental milestones, as well as challenges with speech and learning disabilities, while a higher proportion of adolescents suffer from problems with processing speed, executive function, and a unique set of medical hardships related to exercise intolerance and obesity, medication burden, and mental health comorbidities. Innovative perioperative techniques and early psychosocial intervention in these young survivors has shown that despite the obstacles, the majority of these children can grow to have fulfilling lives with intelligence and social skills in the normal range. Additionally, a comprehensive medical home aids in optimizing the quality of life for these children and their families.</description><subject>Child</subject><subject>Comorbidity</subject><subject>Developmental Disabilities - epidemiology</subject><subject>Developmental Disabilities - physiopathology</subject><subject>Developmental Disabilities - psychology</subject><subject>Early Intervention (Education)</subject><subject>Educational Status</subject><subject>Executive Function</subject><subject>Exercise Tolerance - physiology</subject><subject>Heart Defects, Congenital - physiopathology</subject><subject>Heart Defects, Congenital - psychology</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Humans</subject><subject>Learning Disorders - epidemiology</subject><subject>Learning Disorders - physiopathology</subject><subject>Learning Disorders - psychology</subject><subject>Neonatal and Perinatal Medicine</subject><subject>Obesity - epidemiology</subject><subject>Obesity - physiopathology</subject><subject>Obesity - psychology</subject><subject>Patient-Centered Care</subject><subject>Quality of Life</subject><subject>Survivors - psychology</subject><subject>United States</subject><issn>0146-0005</issn><issn>1558-075X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU-LFDEQxYMo7rj6EZQcPWy3lf6fiyKLq8KCBxW8SEhXqpeM6WQ26V6Yb2-aGT148ZRAvfeK-j3GXgooBbT1m32ZaD5QtGUFoitBlgDDI7YTbTsU0Lc_HrMdiKYrAKC9YM9S2gPUjRTwlF1UvRxk3Tc79vNm9bjY4LW74verdnY58jBxZye64tob7mmNwdADuXCYyS_a8bAuGGZKXE8LRY7B35G32wR1NFYjT2u8o3h8zp5M2iV6cX4v2febD9-uPxW3Xz5-vn5_W2BTwVJg1ciORk19O_YT9qaTHdT5g9U0gBR6NNWAsm-g1pIA81Q2umpGg8ZIGutL9vqUe4jhfqW0qNkmJOe0p7AmJYZWVFLUbZOl7UmKMaQUaVKHaGcdj0qA2siqvTqTVRtZBVJlstn36rxiHWcyf11_UGbBu5OA8qEPlqJKaMkjGRsJF2WC_e-Kt_8koLPeona_6EhpH9aYa8rXqFQpUF-3erd2RVdne879DW7eo8g</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Ringle, Megan L., MD, MPH</creator><creator>Wernovsky, Gil, MD</creator><general>Elsevier Inc</general><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></search><sort><creationdate>20161201</creationdate><title>Functional, quality of life, and neurodevelopmental outcomes after congenital cardiac surgery</title><author>Ringle, Megan L., MD, MPH ; Wernovsky, Gil, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-c2496ebae75b7fc7d69603fc7c2f8091abd28c97403a9e0c96094a24bdcdd9eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Child</topic><topic>Comorbidity</topic><topic>Developmental Disabilities - epidemiology</topic><topic>Developmental Disabilities - physiopathology</topic><topic>Developmental Disabilities - psychology</topic><topic>Early Intervention (Education)</topic><topic>Educational Status</topic><topic>Executive Function</topic><topic>Exercise Tolerance - physiology</topic><topic>Heart Defects, Congenital - physiopathology</topic><topic>Heart Defects, Congenital - psychology</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Humans</topic><topic>Learning Disorders - epidemiology</topic><topic>Learning Disorders - physiopathology</topic><topic>Learning Disorders - psychology</topic><topic>Neonatal and Perinatal Medicine</topic><topic>Obesity - epidemiology</topic><topic>Obesity - physiopathology</topic><topic>Obesity - psychology</topic><topic>Patient-Centered Care</topic><topic>Quality of Life</topic><topic>Survivors - psychology</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ringle, Megan L., MD, MPH</creatorcontrib><creatorcontrib>Wernovsky, Gil, MD</creatorcontrib><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><jtitle>Seminars in perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ringle, Megan L., MD, MPH</au><au>Wernovsky, Gil, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Functional, quality of life, and neurodevelopmental outcomes after congenital cardiac surgery</atitle><jtitle>Seminars in perinatology</jtitle><addtitle>Semin Perinatol</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>40</volume><issue>8</issue><spage>556</spage><epage>570</epage><pages>556-570</pages><issn>0146-0005</issn><eissn>1558-075X</eissn><abstract>Abstract Throughout the past few decades, advances in cardiology, neonatal intensive care, and surgical techniques have resulted in a growing cohort of thriving school-aged children with previously lethal complex congenital heart diseases. 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subjects | Child Comorbidity Developmental Disabilities - epidemiology Developmental Disabilities - physiopathology Developmental Disabilities - psychology Early Intervention (Education) Educational Status Executive Function Exercise Tolerance - physiology Heart Defects, Congenital - physiopathology Heart Defects, Congenital - psychology Heart Defects, Congenital - surgery Humans Learning Disorders - epidemiology Learning Disorders - physiopathology Learning Disorders - psychology Neonatal and Perinatal Medicine Obesity - epidemiology Obesity - physiopathology Obesity - psychology Patient-Centered Care Quality of Life Survivors - psychology United States |
title | Functional, quality of life, and neurodevelopmental outcomes after congenital cardiac surgery |
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