Two-year neurodevelopmental outcomes of infants undergoing neonatal cardiac surgery for interrupted aortic arch: A descriptive analysis

Joynt, Chloë; Robertson, Charlene M.T.; Cheung, Po-Yin; Nettel-Aguirre, Alberto; Joffe, Ari R.; Sauvé, Reg; Biggs, Wayne S.G.; Leonard, Norma; Rebeyka, Ivan M.

doi:10.1016/j.jtcvs.2009.03.016

Cited by 17 publications

(18 citation statements)

References 31 publications

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“…As an unexpected finding, we found that aboriginal children were markedly over represented in this group compared with the rest of our population. We have also published on the outcomes of children with interrupted aortic arch without chromosomal anomalies [66] and children with complex cardiac surgery in the neonatal period who have deletion 22q11.2 [7]. The latter are at a high risk for adverse neurodevelopmental outcomes.…”

Section: Resultsmentioning

confidence: 99%

The Registry and Follow-Up of Complex Pediatric Therapies Program of Western Canada: A Mechanism for Service, Audit, and Research after Life-Saving Therapies for Young Children

Robertson

Sauvé

Joffe

et al. 2011

Cardiology Research and Practice

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Newly emerging health technologies are being developed to care for children with complex cardiac defects. Neurodevelopmental and childhood school-related outcomes are of great interest to parents of children receiving this care, care providers, and healthcare administrators. Since the 1970s, neonatal follow-up clinics have provided service, audit, and research for preterm infants as care for these at-risk children evolved. We have chosen to present for this issue the mechanism for longitudinal follow-up of survivors that we have developed for western Canada patterned after neonatal follow-up. Our program provides registration for young children receiving complex cardiac surgery, heart transplantation, ventricular assist device support, and extracorporeal life support among others. The program includes multidisciplinary assessments with appropriate neurodevelopmental intervention, active quality improvement evaluations, and outcomes research. Through this mechanism, consistently high (96%) follow-up over two years is maintained.

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Section: Resultsmentioning

confidence: 99%

The Registry and Follow-Up of Complex Pediatric Therapies Program of Western Canada: A Mechanism for Service, Audit, and Research after Life-Saving Therapies for Young Children

Robertson

Sauvé

Joffe

et al. 2011

Cardiology Research and Practice

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“…Serious CHDs were studied collectively, with the exception of IAA-B, due to a previously reported association of ID with 22q11.2DS in IAA. 11 We also studied neonatal cyanosis unexplained by either neonatal hypocalcemia or serious CHD. We recorded family history of ID (n = 4) and epilepsy (n = 2) in first-degree relatives of subjects, excluding relatives with proven or probable 22q11.2DS.…”

Section: Evaluationsmentioning

confidence: 99%

Neonatal hypocalcemia, neonatal seizures, and intellectual disability in 22q11.2 deletion syndrome

Cheung

George

Andrade

et al. 2014

Genetics in Medicine

103

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“…Previous research on IAA focused on early mortality and re-intervention rate, demonstrating variable perioperative mortality[2, 4-6], with most recent reporting mortality of 3.6% at 2 years[7] and 39% at 21 years[6]. We report data on survivors and cannot comment on how mortality in our cohort compares with previous studies.…”

Section: Discussionmentioning

confidence: 72%

“…For both strategies, risks of mortality and re-intervention have been described[2-6]. To date, other aspects of the clinical status of subjects who survive surgery have received less attention, other than a single study that demonstrated worse neurodevelopmental outcomes in IAA patients at 2 years of age[7]. In this study, we sought to provide a cross-sectional multi-dimensional characterization of clinical status in this population in school-age and adolescent survivors after operative correction as well as retrospective data regarding their rates of re-intervention and utilization of health care resources.…”

Section: Introductionmentioning

confidence: 99%

Morbidity in Children and Adolescents After Surgical Correction of Interrupted Aortic Arch

et al. 2013

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Background Previous studies of outcome following operative correction of interrupted aortic arch (IAA) focus on mortality and rates of re-intervention. We sought to investigate the clinical status of children and adolescents following surgery for interrupted aortic arch (IAA). Methods A cross-sectional study of subjects with IAA between the ages of 8-18 years was performed with subject undergoing concurrent genetic testing, electrocardiogram, cardiac magnetic resonance imaging, cardiopulmonary exercise testing, and assessment of health status and health-related quality of life as well as concurrent retrospective cohort study reviewing their post-operative utilization of medical care including operative and trans-catheter reintervention, non-cardiac operations, and hospitalizations. Results 21 subjects with IAA with median age of 9 years were studied. Re-intervention rates were 38% on the left ventricular outflow tract, 33% for the aortic arch, and 24% for both. Rates of re-intervention were highest in the first year of life and decreased in subsequent years. Left ventricular ejection fraction was preserved (72±6%). Maximal oxygen consumption, maximal work, and forced vital capacity were both significantly diminished from age and gender norms (p<0.0001). Health status and quality of life were both severely diminished. Conclusion Subjects with IAA demonstrate a significant burden of operative and trans-catheter intervention and large magnitude deficits in exercise performance, health status, and health related quality of life.

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Two-year neurodevelopmental outcomes of infants undergoing neonatal cardiac surgery for interrupted aortic arch: A descriptive analysis

Cited by 17 publications

References 31 publications

The Registry and Follow-Up of Complex Pediatric Therapies Program of Western Canada: A Mechanism for Service, Audit, and Research after Life-Saving Therapies for Young Children

The Registry and Follow-Up of Complex Pediatric Therapies Program of Western Canada: A Mechanism for Service, Audit, and Research after Life-Saving Therapies for Young Children

Neonatal hypocalcemia, neonatal seizures, and intellectual disability in 22q11.2 deletion syndrome

Morbidity in Children and Adolescents After Surgical Correction of Interrupted Aortic Arch

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