TITLE

Mortality and neurodevelopmental outcome at 1 year of age comparing hybrid and Norwood procedures

AUTHOR(S)
Knirsch, Walter; Liamlahi, Rabia; Hug, Maja I.; Hoop, Ricarda; von Rhein, Michael; Prêtre, René; Kretschmar, Oliver; Latal, Beatrice
PUB. DATE
July 2012
SOURCE
European Journal of Cardio-Thoracic Surgery;Jul2012, Vol. 42 Issue 1, p33
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES Neonates with hypoplastic left heart syndrome (HLHS) are at risk of high mortality and neurodevelopmental morbidity. As an alternative to Norwood-type stage I palliation, the hybrid procedure has been developed. It consists of bilateral pulmonary artery banding, catheter-based stenting of the arterial duct and balloon atrioseptostomy and delays open-heart surgery. Thus, it may be associated with a better outcome. The aim of this study was to determine the mortality and neurodevelopmental outcome in patients with HLHS and other univentricular heart (UVH) defects treated with hybrid or Norwood procedures. METHODS Thirty-one children (18 males) with HLHS and other UVH defects undergoing Norwood or hybrid procedure between 2004 and 2008 were consecutively enrolled. Mortality and neurodevelopmental outcome at 1 year of age were determined. RESULTS One-year mortality was 36% (31% in the hybrid vs. 39% in the Norwood group, P = 0.71). Predictors of mortality were lower birth weight (P = 0.02), older age at first procedure (P = 0.02) and smaller size of ascending aorta (P = 0.05). Overall, median psychomotor development index (PDI) and mental development index (MDI) of the Bayley Scales of Infant Development II were lower than the norm of 100 [PDI 57 (49–99), P < 0.001; MDI 91 (65–109), P = 0.002]. No effect of surgical treatment on neurodevelopmental outcome was found. Predictors of impaired motor outcome were length of hospital stay (LOHS) (P = 0.01), lower body weight at second procedure (P = 0.004) and female sex (P = 0.01). Predictors of impaired cognitive outcome were longer mechanical ventilation time (P = 0.03), intensive care unit stay (P = 0.04) and LOHS (P < 0.001), respectively. CONCLUSIONS Mortality at 1 year of age is comparable between patients undergoing hybrid and Norwood procedures. Early neurodevelopmental outcome is significantly impaired in patients with both HLHS and other UVH defects. Multicentre randomized studies are needed to determine the long-term neurodevelopmental outcome of children treated with the hybrid procedure.
ACCESSION #
77686473

 

Related Articles

  • Perinatal Outcomes of Multiple Births in Southwest Nigeria. Olusanya, Bolajoko O. // Journal of Health, Population & Nutrition;Dec2011, Vol. 29 Issue 6, p639 

    Compared to singletons, multiple births are associated with a substantially-higher risk of maternal and perinatal mortality worldwide. However, little evidence exists on the perinatal profile and risk of neurodevelopmental disabilities among the survivors, especially in developing countries....

  • Wrist-ankle acupuncture (WAA) for precompetition nervous syndrome: study protocol for a randomized controlled trial. Shi Shu; Mei Zhan; Yan-li You; Xiao-lu Qian; Chun-ming Li; Cheng-lin Zhou; Shuang Zhou // Trials;9/8/2015, Vol. 16 Issue 1, p1 

    Background: Precompetition nervous syndrome comprises an excessive nervous and anxiety response to the high-pressure environment preceding a sporting competition. The use of acupuncture as a treatment option for anxiety, and wrist-ankle acupuncture (WAA) specifically in this instance, has been...

  • Hipernatremia en 79 recién nacidos. Factores asociados a desenlace adverso. López-Candiani, Carlos; Salamanca-Galicia, Omar // Acta Pediatrica de Mexico;sep/oct2012, Vol. 33 Issue 5, p239 

    Background. Hypernatremia is a pathologic condition that is potentially complicated with neurologic damage or death. The aim of the present was to detect factors associated to adverse outcome in hypernatraemic infant newborns. Material and method. A retrospective study was conducted in newborns...

  • Use of cancer therapy at the end of life in patients with malignant pleural mesothelioma. Kao, Steven; Zandwijk, Nico; Corte, Peter; Clarke, Christopher; Clarke, Stephen; Vardy, Janette // Supportive Care in Cancer;Jul2013, Vol. 21 Issue 7, p1879 

    Purpose: Malignant pleural mesothelioma (MPM) is considered a treatment-resistant disease. We determined the proportion of patients who received treatment in the last month of life and potential factors associated with use of chemotherapy at the end of life. Methods: Consenting MPM patients...

  • Early and late prognostic significance of remote and reversible preoperative neurological events in patients undergoing coronary artery bypass grafting Ngaage, Dumbor L.; Dickson, Joanne; Chaudhry, Mubarak; Cale, Alexander R.; Cowen, Michael E. // European Journal of Cardio-Thoracic Surgery;May2010, Vol. 37 Issue 5, p1075 

    Abstract: Objectives: Preoperative neurological event with functional impairment is high risk for operative morbidity and mortality after coronary artery bypass grafting (CABG). However, data regarding the influence of remote and reversible neurological events on early and late survival are...

  • Feasibility and related outcome of intraluminal pulmonary artery banding. Sandrio, Stany; Purbojo, Ariawan; Arndt, Florian; Toka, Okan; Glöckler, Martin; Dittrich, Sven; Cesnjevar, Robert; Rüffer, André // European Journal of Cardio-Thoracic Surgery;Sep2015, Vol. 48 Issue 3, p470 

    OBJECTIVES: This retrospective study evaluated the feasibility and related outcome of intraluminal pulmonary artery banding (I-PAB). METHODS: Thirty-two children underwent I-PAB between July 2006 and April 2014. The median age and weight were 60 days (range: 5 days to 4.2 years) and 3.7 kg...

  • Impact of either short- or long-term right heart support on continuous flow LVAD outcomes. Rao, S.; Shehab, S.; Lewis, J.; De Silva, K.; Desiree, R.; Connellan, M.; Macdonald, P.; Keogh, A.; Jabbour, A.; Kotlyar, E.; Granger, E.; Spratt, P.; Dhital, K.; Jansz, P.; Hayward, C. // Heart, Lung & Circulation;2015 Supplement 3, Vol. 24, pS208 

    No abstract available.

  • Neurological Response to cART vs. cART plus Integrase Inhibitor and CCR5 Antagonist Initiated during Acute HIV. Valcour, Victor G.; Spudich, Serena S.; Sailasuta, Napapon; Phanuphak, Nittaya; Lerdlum, Sukalaya; Fletcher, James L. K.; Kroon, Eugene D. M. B.; Jagodzinski, Linda L.; Allen, Isabel E.; Adams, Collin L.; Prueksakaew, Peeriya; Slike, Bonnie M.; Hellmuth, Joanna M.; Kim, Jerome H.; Ananworanich, Jintanat; null, null // PLoS ONE;10/11/2015, Vol. 10 Issue 10, p1 

    Objective: To compare central nervous system (CNS) outcomes in participants treated during acute HIV infection with standard combination antiretroviral therapy (cART) vs. cART plus integrase inhibitor and CCR5 antagonist (cART+). Design: 24-week randomized open-label prospective evaluation....

  • The prognostic value of amplitude-integrated electroencephalography in neonates with hypoxic-ischemic encephalopathy. Vasiljević, Brankica; Maglajlić-Djukić, Svjetlana; Gojnić, Miroslava // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Jun2012, Vol. 69 Issue 6, p492 

    Background/Aim. Diagnosis of perinatal hypoxic-ischemic encephalopathy (HIE) and early prediction neurological outcome is important and difficult. The aim of this study was to determine the prognostic value of amplitude-integrated electroencephalography (aEEG) for abnormal neurodevelopment...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics