Original articleCongenital heart surgeryNeurodevelopmental Delay After the Neonatal Repair of Coarctation and Arch Obstruction
Section snippets
Patients and Methods
After approval by the institutional review board and informed consent, parents of children who underwent Iso CoA repair or AR at 30 or fewer days of age within our consortium from 2001 through 2016 were recruited.22 Children with single ventricle physiology, cyanotic CHD in conjunction with coarctation (CoA), and known genetic syndromes were excluded. Parents of children referred to our consortium’s pediatric cardiology practice for evaluation of an innocent heart murmur from 2016 to 2017 who
Preoperative Demographic Characteristics
From 158 neonates with CoA 99 met inclusion criteria and were targeted for recruitment (Figure 1). Neurodevelopmental outcomes were obtained from 60 children, 50 after the repair of CoA (12 for Iso CoA, 38 for AR) and 10 healthy control patients. No statistically significant differences were found in operative age, weight, preoperative mechanical ventilation, or presence of preoperative shock between the groups (Table 1). There were no abnormal preoperative cranial ultrasound scans in the Iso
Comment
This study provides a focused evaluation of NDD prevalence after the biventricular repair of CoA. Neonates who underwent repair of CoA fared significantly worse than healthy control patients in their communication, socialization, activities of daily living, and correspondingly in their overall composite scores. The rate of NDD observed in this cohort is similar to previous reports of other types of repaired CHD.12, 28 Despite being acyanotic and lacking traditional risk factors for NDD, the
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