Neurodevelopmental and neuroradiologic outcomes in patients with univentricular heart aged 5 to 7 years: Related risk factor analysis
Open accessAbstract
Objective Despite improved survival and neurodevelopmental outcome, children with hypoplastic left heart syndrome and other forms of univentricular heart remain at increased risk for cognitive, motor, and other neurologic deficits.Methods We examined 27 children with hypoplastic left heart syndrome or other forms of univentricular heart at a median age of 5.70 years (range 4.99-7.51 years) and performed brain computed tomography or magnetic resonance imaging on 20. Possible risk factors were correlated with outcome.Results Mean full-scale IQ among patients with hypoplastic left heart syndrome was 86.7; that among patients with other forms of univentricular heart was 89.1, with both differing significantly from the expected population mean (P = .015 and P = .029, respectively). Cerebral palsy was diagnosed in 1 of 7 patients with hypoplastic left heart syndrome and 2 of 20 with other forms of univentricular heart. Brain computed tomography or magnetic resonance imaging revealed ischemic changes and infarcts or atrophy in 5 of 8 patients who had undergone the Norwood procedure and in 2 of 12 of those who had not (P = .062). Abnormal computed tomographic findings correlated significantly with lower full-scale IQ (P = .045) and verbal IQ (P = .02). In the multiple linear regression model, diuresis the third day after the primary operation and cardiopulmonary bypass time in the bidirectional Glenn operation correlated significantly with the primary outcome of full-scale IQ.Conclusion In children with univentricular heart, intellectual and neurologic deficits are common. Perioperative and postoperative risk factors related to the primary phase and bidirectional Glenn operation contribute to these deficits.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
At school age, motor developmental delays persist in children with all types of congenital heart disease, and IQ is lower than the population average.
“At school age, motor developmental delays persist in children with all types of CHD 11 and IQs are lower than in the average population.[12][13][14]”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [12]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Complement and the damaging effects of cardiopulmonary bypass
Kirklin, J. K., Westaby, S., Blackstone, E. H., Kirklin, J. W., Chenoweth, D. E., & Pacifico, A. D. (1983) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)39061-0 · Cited by 1,322 · see citing works
NEPSY : A Developmental Neuropsychological Assessment
Dumont, R., & Willis, J. O. (2008) · Wiley eBooks · doi:10.1002/9780470373699.speced1463 · Cited by 775 · see citing works
Bellinger, D. C., Wypij, D., duPlessis, A. J., Rappaport, L. A., Jonas, R. A., Wernovsky, G., & Newburger, J. W. (2003) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(03)00711-6 · Cited by 681 · see citing works
NEPSY, Developmental Neuropsychological Assessment
Kreutzer, J. S., DeLuca, J., & Caplan, B. (2010) · Springer eBooks · doi:10.1007/978-0-387-79948-3_4835 · Cited by 672 · see citing works
An MRI Study of Neurological Injury Before and After Congenital Heart Surgery
Mahle, W. T., Tavani, F., Zimmerman, R. A., Nicolson, S. C., Galli, K. K., Gaynor, J. W., Clancy, R. R., Montenegro, L. M., Spray, T. L., Chiavacci, R. M., et al. (2002) · Circulation · doi:10.1161/01.cir.0000032908.33237.b1 · Cited by 541 · see citing works
NEPSY: A Developmental Neuropsychological Assessment
Ph.D., S. G., & Ph.D., J. A. N. (2011) · Springer eBooks · doi:10.1007/978-0-387-79061-9_5508 · Cited by 519 · see citing works
Mahle, W. T., Clancy, R. R., Moss, E., Gerdes, M., Jobes, D. R., & Wernovsky, G. (2000) · PEDIATRICS · doi:10.1542/peds.105.5.1082 · Cited by 463 · see citing works
Periventricular leukomalacia is common after neonatal cardiac surgery
Galli, K. K., Zimmerman, R. A., Jarvik, G. P., Wernovsky, G., Kuypers, M., Clancy, R. R., Montenegro, L. M., Mahle, W. T., Newman, M. F., Saunders, A. M., et al. (2004) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2003.09.053 · Cited by 352 · see citing works
Srinivasan, V., Spinella, P. C., Drott, H. R., Roth, C., Helfaer, M. A., & Nadkarni, V. (2004) · Pediatric Critical Care Medicine · doi:10.1097/01.pcc.0000128607.68261.7c · Cited by 338 · see citing works
Cognitive Development After the Fontan Operation
Wernovsky, G., Stiles, K. M., Gauvreau, K., Gentles, T. L., duPlessis, A. J., Bellinger, D. C., Walsh, A. Z., Burnett, J. T., Jonas, R. A., Mayer, J. E., et al. (2000) · Circulation · doi:10.1161/01.cir.102.8.883 · Cited by 272 · see citing works
Cerebral microembolism during cardiopulmonary bypass
Blauth, C. I., Arnold, J. V., Schulenburg, W. E., McCartney, A. C. E., Taylor, K. M., & Loop, F. D. (1988) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)35735-6 · Cited by 249 · see citing works
Goldberg, C. S., Schwartz, E. M., Brunberg, J. A., Mosca, R. S., Bove, E. L., Schork, M. A., Stetz, S. P., Cheatham, J. P., & Kulik, T. J. (2000) · The Journal of Pediatrics · doi:10.1067/mpd.2000.108952 · Cited by 220 · see citing works
Neuropsychological and neuropathological sequelae of cerebral anoxia: A critical review
Caine, D., & Watson, J. D. G. (2000) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617700611116 · Cited by 214 · see citing works
Neurodevelopmental outcome of infants with hypoplastic left heart syndrome
Rogers, B., Msall, M. E., Louis, G. M. B., Lyon, N., Norris, M., Roland, J.-M. A., Gingell, R. L., Cleveland, D. C., & Pieroni, D. R. (1995) · The Journal of Pediatrics · doi:10.1016/s0022-3476(95)70478-7 · Cited by 189 · see citing works
Neurodevelopmental Outcome After Congenital Heart Surgery: Results From an Institutional Registry
Forbess, J. M., Visconti, K. J., Hancock-Friesen, C. L., Howe, R. C., Bellinger, D. C., & Jonas, R. A. (2002) · Circulation · doi:10.1161/01.cir.0000032915.33237.72 · Cited by 177 · see citing works
Early Developmental Outcome After the Norwood Procedure for Hypoplastic Left Heart Syndrome
Kern, J. H., Hinton, V. J., Nereo, N. E., Hayes, C. J., & Gersony, W. M. (1998) · PEDIATRICS · doi:10.1542/peds.102.5.1148 · Cited by 140 · see citing works
Outcome After Open-Heart Surgery in Infants and Children
Miller, G., Tesman, J. R., Ramer, J. C., Baylen, B. G., & Myers, J. L. (1996) · Journal of Child Neurology · doi:10.1177/088307389601100112 · Cited by 129 · see citing works
Connolly, D., Rutkowski, M. M., Auslender, M., et al. (2001) · The Journal of Pediatrics · doi:10.1067/mpd.2001.114020 · Cited by 104 · see citing works
Neurodevelopmental Outcomes in Children With Fontan Repair of Functional Single Ventricle
Uzark, K. C., Lincoln, A. J., Lamberti, J. J., Mainwaring, R. D., Spicer, R. L., & Moore, J. W. (1998) · PEDIATRICS · doi:10.1542/peds.101.4.630 · Cited by 100 · see citing works
de Ferranti, S. D., Gauvreau, K., Hickey, P. R., Jonas, R. A., Wypij, D., du Plessis, A., Bellinger, D. C., Kuban, K., Newburger, J. W., & Laussen, P. C. (2004) · Anesthesiology · doi:10.1097/00000542-200406000-00005 · Cited by 92 · see citing works
Berdat, P. A., Belli, E., Lacour-Gayet, F. G., et al. (2004) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2004.06.002 · Cited by 85 · see citing works
Mechanisms of brain injury during infant cardiac surgery
du Plessis, A. J. (1999) · Seminars in Pediatric Neurology · doi:10.1016/s1071-9091(99)80045-x · Cited by 83 · see citing works
NEURODEVELOPMENTAL SCREENING IN THE SCHOOL-ENTRANT MEDICAL EXAMINATION
BAX, M. C. O., & Whitmore, K. (1973) · The Lancet · doi:10.1016/s0140-6736(73)93205-4 · Cited by 72 · see citing works
Neurodevelopmental Outcomes in Children After the Fontan Operation
Forbess, J. M., Visconti, K. J., Bellinger, D. C., & Jonas, R. A. (2001) · Circulation · doi:10.1161/hc37t1.094816 · Cited by 72 · see citing works
Long-Term MRI Changes in Brain After Pediatric Open Heart Surgery
Miller, G., Mamourian, A. C., Tesman, J. R., Baylen, B. G., & Myers, J. L. (1994) · Journal of Child Neurology · doi:10.1177/088307389400900411 · Cited by 71 · see citing works
Cerebral autoregulation during moderate hypothermia in rats.
Verhaegen, M., Todd, M. M., Hindman, B. J., et al. (1993) · Stroke · doi:10.1161/01.str.24.3.407 · Cited by 66 · see citing works
Neurological Protection During Cardiopulmonary Bypass/Deep Hypothermia
Jonas, R. A. (1998) · Pediatric Cardiology · doi:10.1007/s002469900317 · Cited by 47 · see citing works
Brain injury in children with congenital heart disease
Scallan, M. J. H. (2003) · Pediatric Anesthesia · doi:10.1046/j.1460-9592.2003.00996.x · Cited by 38 · see citing works
Karmazyn, B. W., Dagan, O., Vidne, B., et al. (2002) · Pediatric Radiology · doi:10.1007/s00247-002-0770-z · Cited by 28 · see citing works
CHARACTER AND TREATMENT OF THE MALIGNANT CHOLERA AT LIVERPOOL.
Murphy, T. (1832) · The Lancet · doi:10.1016/s0140-6736(02)94627-1 · Cited by 7 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Beery K. The Beery-Buktenica developmental test of visual-motor integration. VMI with supplemental developmental tests of visual perception and motor coordination: administration, scoring and teach- ing manual. 1st ed. Parsippany (NJ): Modern Curriculum Press; 1997.
Cited by
Sorted by citations
A Systematic Review of Motor and Cognitive Outcomes After Early Surgery for Congenital Heart Disease
Snookes, S. H., Gunn, J. K., Eldridge, B. J., Donath, S. M., Hunt, R. W., Galea, M. P., & Shekerdemian, L. (2010) · Pediatrics · doi:10.1542/peds.2009-1959 · Cited by 260 · see citing works
Perioperative risk factors for impaired neurodevelopment after cardiac surgery in early infancy
Gunn, J. K., Beca, J., Hunt, R. W., Goldsworthy, M., Brizard, C. P., Finucane, K., Donath, S., & Shekerdemian, L. S. (2016) · Archives of Disease in Childhood · doi:10.1136/archdischild-2015-309449 · Cited by 92 · see citing works
The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome
Wernovsky, G. (2008) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.162.9.849 · Cited by 71 · see citing works
Claessens, N. H. P., Kelly, C. J., Counsell, S. J., & Benders, M. J. N. L. (2017) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.13461 · Cited by 59 · see citing works
- Authors
- Sarajuuri, A., Jokinen, E., Puosi, R., Eronen, M., Mildh, L., Mattila, I., Valanne, L., & Lönnqvist, T.
- Affiliations
- Helsinki University Hospital (FI)
- Corresponding author
- Sarajuuri, Anne
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 2007-06
- Volume
- 133
- Issue
- 6
- Pages
- 1524-1532
- ISSN
- 0022-5223 (ISSN-L)
- OpenAlex
- W2071779419
- Cited by
- 61
- References
- 31
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 6 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 8 · 2012: 8
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Lastentautien Tutkimussäätiö
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Keywords
- single ventricle, hypoplastic left heart syndrome, neurodevelopmental outcomes, cognitive impairment, cerebral palsy, brain MRI abnormalities, Norwood procedure, cardiopulmonary bypass time, diuresis, risk factors
- MeSH terms
- Child, Developmental Disabilities, Child, Preschool, Cognition Disorders, Female, Humans, Intelligence Tests, Magnetic Resonance Imaging, Male, Neurologic Examination, Neuropsychological Tests, Psychomotor Performance, Risk Factors, Tomography, X-Ray Computed, Linear Models, Hypoplastic Left Heart Syndrome, Statistics, Nonparametric
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
