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Early Neurodevelopmental Outcomes After Corrective Cardiac Surgery In Infants.

Publisher : Indian Pediatr

Campus : Kochi

School : School of Medicine

Department : Paediatric Cardiology

Verified : No

Year : 2018

Abstract :

OBJECTIVE: To assess neurodevelopmental status in Indian infants undergoing corrective surgery for congenital heart disease (CHD) and to analyze factors associated with neurodevelopmental delay.

DESIGN: Cross-sectional study.

SETTING: Tertiary-care pediatric cardiology facility.

PARTICIPANTS: Consecutive infants undergoing corrective surgery for CHD (January 2013 -December 2014). Palliative procedures, and patients with known genetic syndromes were excluded.

MAIN OUTCOME MEASURES: Neurodevelopmental evaluation 3 months, and one year after surgery using Developmental Assessment Scales for Indian Infants (DASII); scores were categorized as delayed if ≤70.

RESULTS: Of the 162 children enrolled, delayed PDI and MDI scores were observed in 33.5% and 19.6% of patients at 3 months, respectively; this reduced to 14.5%on 1-year follow-up. On multivariate analysis, delayed PDI outcome at one year was predicted by early term birth and one-year postoperative head circumference Z-score <-2. Delayed MDI was associated with higher mean perfusion pressure on cardiopulmonary bypass. Cardiac diagnosis and peri-operative factors did not impact neurodevelopmental outcomes.

CONCLUSIONS: Neurodevelopmental status is delayed in 14.5% of infants one year after corrective infant heart surgery.

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