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Cognitive P300-evoked potentials in school-age children after surgical or transcatheter intervention for ventricular
Guo-Tao Guan1, You-Peng Jin, Rui-Ping Zheng
1Division of Cardiology, Department of Pediatrics, Provincial Hospital affiliated to Shandong University, Shandong University, Jinan, China.
Insights
Children with ventricular septal defect (VSD) may experience impaired cognitive function, particularly after surgical repair involving cardiopulmonary bypass (CPB). This cognitive deficit is linked to the duration of CPB and aortic clamping during surgery.
Area of Science:
- Pediatric Cardiology
- Neuroscience
- Developmental Biology
Background:
- Neurological development concerns exist for children with severe heart disease undergoing prolonged cardiopulmonary bypass (CPB).
- Limited data is available on cognitive function in ventricular septal defect (VSD) patients with shorter CPB durations.
- Transcatheter closure of VSD bypasses the need for CPB.
Purpose of the Study:
- To evaluate cognitive function in patients diagnosed with ventricular septal defect (VSD).
Main Methods:
- Cognitive P300 auditory-evoked potentials and intelligence tests were administered to 29 surgically treated VSD patients, 35 transcatheter-closed VSD patients, and their matched controls.
- Comparison of cognitive test results between VSD patient groups and healthy controls.
Main Results:
- All groups exhibited normal intelligence quotients.
- VSD patients demonstrated significantly longer P300 peak latencies in frontal and vertex regions compared to controls (p < 0.05).
- Surgically treated VSD patients showed longer P300 latencies than transcatheter-treated patients and controls; longer CPB and aortic clamping times correlated with increased P300 latency.
Conclusions:
- VSD patients, particularly those undergoing surgical repair, exhibit poorer cognitive function.
- The duration of cardiopulmonary bypass and aortic clamping during surgery may be associated with cognitive deficits in VSD patients.
Background:
Some studies have suggested that neurological development may be adversely affected in children with severe coronary heart disease who have undergone long periods of deep hypothermic cardiopulmonary bypass (CPB). Reports of cognitive function in VSD patients in whom surgical repair required only a relatively brief period of CPB are rare. Also, CPB is unnecessary for VSD patients undergoing transcatheter closure. The aim of this study was to assess the cognitive function in patients with ventricular septal defect.
Methods:
A total of 29 patients treated with surgery, and 35 treated with transcatheter closure and their age- and sex-matched best friends completed the cognitive P300 auditory-evoked potentials test and the intelligence test.
Results:
The patients and their best friends had normal intelligence quotient; however, the patients had longer P300 peak latencies in cranial frontal lobe and cranial vertex leads (329.2 ± 24.8 and 335.1 ± 20.0 ms) than the healthy controls did (319.1 ± 20.6 and 313 ± 18.2 ms) (P < 0.05). Patients who underwent surgery had longer P300 peak latency in the cranial frontal lobe and cranial vertex leads than did those with transcatheter closure and controls. When cardiopulmonary bypass and aortic clamping were used, the duration was associated with P300 peak latency for patients (P < 0.05).
Conclusion:
VSD patients, especially those undergoing surgery, showed poor cognitive function, which may be associated with duration of cardiopulmonary bypass or aortic-clamping.
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