Neurodevelopmental Outcomes in Children After the Fontan Operation
| Autor: | Joseph M. Forbess, Richard A. Jonas, David C. Bellinger, Karen J. Visconti |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male congenital hereditary and neonatal diseases and abnormalities Pediatrics medicine.medical_specialty Adolescent medicine.medical_treatment Population Neuropsychological Tests Fontan Procedure Risk Assessment Time Cohort Studies Fontan procedure Risk Factors Physiology (medical) Humans Medicine cardiovascular diseases Child education Intelligence Tests education.field_of_study Intelligence quotient Learning Disabilities business.industry Wechsler Scales Neuropsychology Surgery Clinical trial Treatment Outcome surgical procedures operative El Niño Child Preschool cardiovascular system Female Norwood procedure business Cardiology and Cardiovascular Medicine Follow-Up Studies Cohort study |
| Zdroj: | Circulation. 104 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Background Previous studies of patients after the Fontan operation have reported IQ scores lower than population norms. In the past decade, changes have occurred both in surgical methods used and in the patient population undergoing Fontan palliation. The present study examined the impact of these changes on neurodevelopmental outcomes after Fontan. Methods and Results Neuropsychological tests were administered to 27 five-year-old children after Fontan. Mean age at repair was 2 years 4 months. The present sample was compared with an earlier Fontan group (EFG) of 133 patients who underwent surgery in the 1970s and 1980s. Mean age at repair for the EFG was 7 years 3 months. Compared with EFG, the present study sample was younger at Fontan ( P =0.0001) and more likely to have undergone a Norwood procedure ( P =0.02), a pre-Fontan bidirectional cavopulmonary anastomosis ( P P =0.001). Although mean full-scale, verbal, and performance IQ scores were within 1 SD (15 points) of the population mean of 100 (93±16, 95±15, and 91±17, respectively), mean full-scale and performance IQ scores were significantly lower than this population mean ( P =0.03 and P =0.01, respectively). Conclusions Compared with a historical cohort of Fontan patients from this institution, a staged approach to Fontan earlier in life is not detrimental to neurodevelopmental outcome. Neurodevelopmental outcomes in children after Fontan are in the normal range, but performance remains lower than the general population. |
| Databáze: | OpenAIRE |
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