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Published on: July 18, 2014
Neurodevelopmental outcomes in children surviving d-transposition of the great arteries
K A Ellerbeck1, M L Smith, E W Holden
1Children's Mercy Hospital, Section of Developmental and Behavioral Sciences, Kansas City, MO 64108, USA.
Insights
Children with dextro-transposition of the great arteries (d-TGA) show higher rates of neurological and learning issues. Siblings also exhibited more learning problems, suggesting a potential familial link.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Congenital Heart Disease
Background:
- Dextro-transposition of the great arteries (d-TGA) is a critical congenital heart defect.
- Neurodevelopmental outcomes in d-TGA survivors require further investigation.
- Understanding developmental trajectories is crucial for long-term pediatric care.
Purpose of the Study:
- To determine the prevalence of neurological abnormalities and learning problems in children with d-TGA.
- To compare neurodevelopmental outcomes between d-TGA survivors and their siblings.
- To assess the impact of surgical approach (atrial vs. arterial switch) on neurological outcomes.
Main Methods:
- Population-based cohort study of children born between 1981 and 1990.
- Neurodevelopmental assessments conducted on 57 d-TGA survivors and 35 siblings.
- Comparison of findings with population norms and sibling controls.
Main Results:
- Children with d-TGA exhibited significantly more abnormal neurological findings, learning disabilities, and behavioral disorders than population norms.
- No significant differences in IQ or neurological findings were observed between atrial and arterial switch procedures.
- d-TGA survivors had more neurological and learning issues compared to siblings.
- Siblings of d-TGA children showed a higher prevalence of learning problems than expected.
Conclusions:
- Ongoing neurodevelopmental surveillance is essential for children surviving d-TGA.
- A familial predisposition to learning differences may influence outcomes in d-TGA populations.
- Consideration of familial factors is important when evaluating perioperative neurodevelopmental outcomes.
Abstract:
We investigated the prevalence of neurological abnormalities and learning problems in a population cohort of children with dextro-transposition of the great arteries (d-TGA) born between January 1, 1981 and July 1, 1990. Fifty-seven of the 60 survivors and 35 siblings in the control group underwent neurodevelopmental assessments. As compared with population norms, children with d-TGA were more likely to have abnormal neurological examination findings, learning disabilities, and behavioral disorders. There was no significant difference in IQ or frequency of abnormal neurological examination results between children undergoing atrial as compared with arterial switch procedures. Compared with their siblings, the children with d-TGA had more neurological findings and learning disabilities. The siblings of children with d-TGA had more learning problems than expected. The findings suggest that ongoing surveillance is indicated for children surviving d-TGA. Furthermore, a familial tendency for learning differences should to be taken into consideration when neurodevelopmental outcomes of various perioperative parameters are examined.
