Document Detail


Adolescents with d-transposition of the great arteries corrected with the arterial switch procedure: neuropsychological assessment and structural brain imaging.
MedLine Citation:
PMID:  21875911     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We report neuropsychological and structural brain imaging assessments in children 16 years of age with d-transposition of the great arteries who underwent the arterial switch operation as infants. Children were randomly assigned to a vital organ support method, deep hypothermia with either total circulatory arrest or continuous low-flow cardiopulmonary bypass.
METHODS AND RESULTS: Of 159 eligible adolescents, 139 (87%) participated. Academic achievement, memory, executive functions, visual-spatial skills, attention, and social cognition were assessed. Few significant treatment group differences were found. The occurrence of seizures in the postoperative period was the medical variable most consistently related to worse outcomes. The scores of both treatment groups tended to be lower than those of the test normative populations, with substantial proportions scoring ≥1 SDs below the expected mean. Although the test scores of most adolescents in this trial cohort are in the average range, a substantial proportion have received remedial academic or behavioral services (65%). Magnetic resonance imaging abnormalities were more frequent in the d-transposition of the great arteries group (33%) than in a referent group (4%).
CONCLUSIONS: Adolescents with d-transposition of the great arteries who have undergone the arterial switch operation are at increased neurodevelopmental risk. These data suggest that children with congenital heart disease may benefit from ongoing surveillance to identify emerging difficulties.
CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000470.
Authors:
David C Bellinger; David Wypij; Michael J Rivkin; David R DeMaso; Richard L Robertson; Carolyn Dunbar-Masterson; Leonard A Rappaport; Gil Wernovsky; Richard A Jonas; Jane W Newburger
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-08-29
Journal Detail:
Title:  Circulation     Volume:  124     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-20     Completed Date:  2011-11-15     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1361-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Harvard Medical School, Boston, MA 02115, USA. david.bellinger@childrens.harvard.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00000470
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Attention / physiology
Brain / anatomy & histology,  physiology
Cardiac Surgical Procedures / methods,  rehabilitation*,  statistics & numerical data
Cardiopulmonary Bypass / methods,  rehabilitation*,  statistics & numerical data
Child
Cognition / physiology*
Educational Status
Executive Function / physiology
Follow-Up Studies
Heart Arrest, Induced / methods,  rehabilitation*,  statistics & numerical data
Humans
Hypothermia, Induced / methods,  statistics & numerical data
Infant
Magnetic Resonance Imaging / methods
Memory / physiology
Neuropsychological Tests
Postoperative Complications / epidemiology
Psychomotor Performance / physiology
Risk Factors
Social Behavior
Transposition of Great Vessels / epidemiology,  rehabilitation*,  surgery
Grant Support
ID/Acronym/Agency:
HL77681/HL/NHLBI NIH HHS; R01 HL077681-01/HL/NHLBI NIH HHS; RR02172/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Circulation. 2011 Sep 20;124(12):1319-20   [PMID:  21931101 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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