HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Thomas L. Spray J. William Gaynor Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kaltman, J. R. Articles by Gaynor, J. W. Search for Related Content PubMed PubMed Citation Articles by Kaltman, J. R. Articles by Gaynor, J. W. Related Collections Congenital - acyanotic

J Thorac Cardiovasc Surg 2006;131:792-798
© 2006 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Neurodevelopmental outcome after early repair of a ventricular septal defect with or without aortic arch obstruction

^a Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pa
^c Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa
^d Division of Psychology, The Children's Hospital of Philadelphia, Philadelphia, Pa
^e Division of Genetics, The Children's Hospital of Philadelphia, Philadelphia, Pa
^f Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pa
^g Division of Cardiothoracic Anesthesia, The Children's Hospital of Philadelphia, Philadelphia, Pa
^h Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pa
^b Department of Medicine (Medical Genetics), the University of Washington, Seattle, Wash.

Received for publication October 10, 2005; revisions received December 6, 2005; accepted for publication December 12, 2005.

^_* Address for reprints: Jonathan Kaltman, MD, Division of Cardiology, The Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 19104. (Email: kaltman{at}email.chop.edu).

OBJECTIVES: Cross-sectional studies of intermediate-term survivors of infant cardiac surgery have revealed a high frequency of neurodevelopmental disabilities. Few data exist regarding neurodevelopmental outcome of infants undergoing surgical intervention for a ventricular septal defect. The purpose of this study was to evaluate the neurodevelopmental outcome at 1 year of age of children who had surgical repair in infancy of a ventricular septal defect or a ventricular septal defect with aortic arch obstruction.

METHODS: Children who underwent repair of a ventricular septal defect or single-stage repair of a ventricular septal defect with aortic arch obstruction at less than 6 months of age were assessed at 1 year of age by using the Bayley Scales of Infant Development II, which yields the Mental Development Index and the Psychomotor Development Index, both with an expected mean of 100 ± 15.

RESULTS: At 1 year, 55 patients (ventricular septal defect alone = 36; ventricular septal defect with aortic arch obstruction = 19) returned for evaluation. The mean Mental Development Index was 92.6 ± 11.7, with 3 (5%) patients scoring 70 or less. The mean Psychomotor Development Index was 86.1 ± 16.4, with 10 (18%) patients scoring 70 or less. Patients with a suspected or confirmed genetic syndrome had both a lower Mental Development Index score (P = .011) and a lower Psychomotor Development Index score (P = .001). Mental Development Index and Psychomotor Development Index were independent of anatomic (specifically aortic arch obstruction) and intraoperative factors (specifically deep hypothermic circulatory arrest).

CONCLUSIONS: Neurodevelopmental outcome at 1 year of age was within the normal limits for most patients who underwent repair of a ventricular septal defect or a ventricular septal defect with aortic arch obstruction during infancy.

This article has been cited by other articles:

				J. S. Simons, R. Glidden, D. Sheslow, and C. Pizarro Intermediate Neurodevelopmental Outcome After Repair of Ventricular Septal Defect Ann. Thorac. Surg., November 1, 2010; 90(5): 1586 - 1591. [Abstract] [Full Text] [PDF]

				G. Wernovsky Improving neurologic and quality-of-life outcomes in children with congenital heart disease: Past, present, and future J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 240 - 242. [Full Text] [PDF]

				I. Zeltser, G. P. Jarvik, J. Bernbaum, G. Wernovsky, A. S. Nord, M. Gerdes, E. Zackai, R. Clancy, S. C. Nicolson, T. L. Spray, et al. Genetic factors are important determinants of neurodevelopmental outcome after repair of tetralogy of Fallot J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 91 - 97. [Abstract] [Full Text] [PDF]

				B. Alsoufi, S. Cai, J. G. Coles, W. G. Williams, G. S. Van Arsdell, and C. A. Caldarone Outcomes of Different Surgical Strategies in the Treatment of Neonates with Aortic Coarctation and Associated Ventricular Septal Defects Ann. Thorac. Surg., October 1, 2007; 84(4): 1331 - 1337. [Abstract] [Full Text] [PDF]

				M. G. McBride, P. M. Kirshbom, J. W. Gaynor, R. F. Ittenbach, G. Wernovsky, R. R. Clancy, T. B. Flynn, D. M. Hartman, T. L. Spray, R. E. Tanel, et al. Late cardiopulmonary and musculoskeletal exercise performance after repair for total anomalous pulmonary venous connection during infancy J. Thorac. Cardiovasc. Surg., June 1, 2007; 133(6): 1533 - 1539. [Abstract] [Full Text] [PDF]