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Published on: July 30, 2009
A Pilot Feasibility Study of Neurodevelopmental Surveillance After the Fontan Operation Using a Sedation-Free Brain
Kwang Ho Choi1, Hye Jin Baek2, Hyungtae Kim1
1Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan-si 50612, Republic of Korea.
Children who had Fontan surgery often experience neurodevelopmental issues, particularly with working memory and processing speed. An ultrafast, sedation-free MRI protocol showed promise for assessing brain structure in these patients.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Science
- Medical Imaging
Background:
- Children with single-ventricle physiology post-Fontan operation face risks of neurodevelopmental impairment.
- Limited data exists on the neurocognitive profiles of Korean Fontan patients.
Purpose of the Study:
- Characterize neurocognitive profiles in early school-aged Fontan patients.
- Evaluate the feasibility of a sedation-free ultrafast brain MRI protocol for volumetric analysis.
Main Methods:
- Prospective screening of 25 children (grades 1-3, 8-11 years) post-Fontan surgery.
- Neurocognitive evaluation for 11 participants; 4 underwent 3T sedation-free ultrafast brain MRI.
- Exploratory MRI volumetric analysis compared to 6 age-matched controls.
Main Results:
- Mean full-scale intelligence quotient (FSIQ) was 85.2 ± 24.3; 36% had FSIQ < 85.
- Working memory (64%) and processing speed (55%) were most frequently impaired.
- Fontan patients showed trends toward lower cerebellar volumes (very large effect sizes) and white matter abnormalities.
Conclusions:
- School-aged Fontan patients exhibit specific deficits in working memory and processing speed.
- Exploratory MRI suggests reduced cerebellar volumes in Fontan patients.
- Sedation-free ultrafast MRI is feasible for volumetric assessment, aiding future surveillance and early intervention.
