Document Detail


Five-year follow-up of neonates with reconstructed right common carotid arteries after extracorporeal membrane oxygenation.
MedLine Citation:
PMID:  10190916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Serial Doppler ultrasonography and long-term neurodevelopmental follow-up outcomes were evaluated prospectively in neonates whose right common carotid artery (RCCA) was reconstructed after extracorporeal membrane oxygenation (ECMO). METHODS: Children with RCCA reconstruction (n = 34) were monitored for 3.5 to 4.5 years by Doppler ultrasonography for arterial patency, and 28 had IQ testing by 5 years. A comparison group consisted of 35 infants who had RCCA ligation after ECMO. Neonatal electroencephalograms and computed tomography/magnetic resonance imaging scans were also compared. RESULTS: Reconstructions were successful (<50% RCCA stenosis by Doppler ultrasonography) in 26 (76%) of 34 children, 3 (9%) had >/=50% stenosis, and 5 (15%) had occlusion. No significant differences were seen between reconstructed and ligated groups in neonatal complications or ECMO courses. Occurrence of marked neonatal electroencephalographic abnormalities did not differ between groups. Abnormalities on computed tomography/magnetic resonance imaging scans (4 of 31 vs 11 of 29, P =.025) and cerebral palsy (0 of 34 vs 5 of 35, P =.054) were more common in infants with RCCA ligation. No differences were seen in developmental or IQ scores between the 2 groups, and 4 in each group had cognitive handicaps (at least 1 IQ score <70). CONCLUSIONS: Most RCCA reconstructions remained patent, with 24% showing significant stenosis or occlusion. Compared with a historical control group, patients with RCCA reconstruction had fewer brain scan abnormalities and tended to be less likely to have cerebral palsy. RCCA reconstruction after venoarterial ECMO may improve outcome.
Authors:
S A Desai; C Stanley; M Gringlas; D A Merton; P J Wolfson; L Needleman; L J Graziani; S Baumgart
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  134     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-04-30     Completed Date:  1999-04-30     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  428-33     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Divisions of Neonatology and Child Development and Neurology, Wilmington, Deleware, USA.
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Carotid Artery, Common / surgery*,  ultrasonography
Electroencephalography
Extracorporeal Membrane Oxygenation*
Follow-Up Studies
Gestational Age
Humans
Infant, Newborn
Intelligence Tests
Ligation
Magnetic Resonance Imaging
Treatment Outcome
Vascular Patency
Grant Support
ID/Acronym/Agency:
NS-21453/NS/NINDS NIH HHS; NS-27463/NS/NINDS NIH HHS

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


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