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Neurodevelopmental and neuroradiologic outcomes in patients with univentricular heart aged 5 to 7 years: related risk

Anne Sarajuuri1, Eero Jokinen, Riina Puosi

  • 1Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.

The Journal of Thoracic and Cardiovascular Surgery
|May 30, 2007
PubMed

Insights

Children with hypoplastic left heart syndrome and other univentricular heart conditions often experience cognitive and motor deficits. Surgical factors during treatment correlate with these neurological outcomes.

Area of Science:

  • Pediatric Cardiology
  • Neurodevelopmental Pediatrics
  • Congenital Heart Surgery

Background:

  • Children with hypoplastic left heart syndrome (HLHS) and other univentricular heart (UVH) conditions have improved survival but remain at high risk for neurological deficits.
  • Cognitive, motor, and other neurologic impairments are common challenges faced by these children.

Purpose of the Study:

  • To investigate the prevalence of intellectual and neurological deficits in children with HLHS and UVH.
  • To identify potential perioperative and postoperative risk factors contributing to these deficits.

Main Methods:

  • A cohort of 27 children with HLHS or UVH, median age 5.70 years, was studied.
  • Brain imaging (CT or MRI) was performed on 20 participants.
  • Risk factors were correlated with neurodevelopmental outcomes, including IQ and cerebral palsy.

Main Results:

  • Patients with HLHS and UVH showed significantly lower mean full-scale IQ scores compared to the general population.
  • Abnormal findings on brain imaging, particularly ischemic changes and infarcts, were noted in a subset of patients.
  • Diuresis on postoperative day 3 and cardiopulmonary bypass time during the bidirectional Glenn operation were significant predictors of full-scale IQ.

Conclusions:

  • Intellectual and neurological deficits are prevalent in children with univentricular heart conditions.
  • Perioperative and postoperative factors, specifically related to the primary surgical phase and the bidirectional Glenn operation, significantly contribute to the development of these deficits.
Abstract

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