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Predictors of developmental outcomes in children with complete transposition

Published online by Cambridge University Press:  19 August 2008

Alex Gomelsky ,
E. Wayne Holden ,
Kathy A. Ellerbeck  and
Joel I. Brenner
Alex Gomelsky
Affiliation:
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
E. Wayne Holden
Affiliation:
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
Kathy A. Ellerbeck
Affiliation:
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
Joel I. Brenner*
Affiliation:
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
*
Dr Joel I. Brenner, University of Maryland Medical System, 22 S. Greene Street, N5W4O, Baltimore, MD 21201, USA. Tel 410 328 6666; Fax: 410 328 8670
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Abstract

Cognitive, functional, educational achievement and behavioural measures were employed to assess neurobehavioral status in 57 of 60 participants who were initially enrolled in the Baltimore–Washington Infant Study, and who survived surgical correction of complete transposition (concordant atrioventricular and discordant ventriculo-arterial connections). Charts were reviewed to investigate the relationship between birth variables, surgical strategy and developmental outcomes. Higher preoperative weight was associated with better outcomes on the Stanford–Biner Short-term Memory subtest, while lower preoperative oxygen tension was associated with better outcomes on the Abstract/Visual Reasoning subtest and a test of Visual–Motor Integration. Longer total bypass time was associated with poor outcomes on the Short-term Memory subtests. Higher average flow rates during cooling and rewarming were associated with higher scores in the test of short term memory but poorer outcomes on a test for visual motor integration. Longer cooling times were associated with higher scores on the test for Visual–Motor Integration. Patients suffering seizures scored lower on the Stanford–Biner Composite, as well as in their tests of achievement. The data indicate that non-verbal. skills may be particularly sensitive to variations in surgical strategies employed to correct complete transposition. Overt neurological events, such as seizures, were related to global deficits in intellectual functioning. Prospective studies evaluating systemic variations in surgical procedures and attempts to prevent and manage perioperative neurological events are important for further investigation of neurodevelopmental outcomes in children surviving surgical correction.

Keywords

Transposition of the great arteriesdevelopmental outcome
Type
Original Articles
Information
Cardiology in the Young , Volume 8 , Issue 3 , July 1998 , pp. 352 - 357
Copyright
Copyright © Cambridge University Press 1998

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