Neurodevelopmental outcome of patients after the Fontan operation: A comparison between children with hypoplastic left heart syndrome and other functional single ventricle lesions
Neurodevelopmental outcome of patients after the Fontan operation: A comparison between children with hypoplastic left heart syndrome and other functional single ventricle lesions
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DOI：
10.1067/mpd.2000.108952
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发表时间：
2000-11-01
影响因子：
5.1
通讯作者：
Kulik, TJ
中科院分区：
文献类型：
--
作者：
Goldberg, CS;Schwartz, EM;Kulik, TJ
目的：比较左心发育不良综合征(HLHS)、其他功能性单心室病变患者和标准人群的神经发育结局，并探讨功能性单心室(FSV)儿童神经发育结局的预测因素。研究设计：招募Fontan循环患者的时间和年龄队列，参与神经发育测试、行为评估和中枢神经系统成像。韦氏智力测验是NDO的主要测量工具。分析包括HLHS患者与其他有功能的单心室患者的比较。结果：韦氏智力评分平均为101.4+/-5.4.HLHS亚组的平均满分韦氏评分为93.8±-7.3，非HLHS亚组为107.0+/-7.0。尽管HLHS组的得分显著低于非HLHS亚组，但两个亚组的韦氏惊恐评分均不同于标准人群。社会经济状况、循环骤停和围手术期癫痫发作也是神经发育结局的预测因素。结论：接受Fontan手术的患者，包括HLHS患者，在学龄前和学龄早期神经发育和行为结局良好，韦氏智力评分总体在正常范围。
Objective: To compare neurodevelopmental outcome (NDO) in patients with hypoplastic left heart syndrome (HLHS), other functional single ventricle lesions, and the standard population and to investigate predictors of NDO in the population of children with functional single ventricle (FSV).Study design: A time- and age-defined cohort of patients with the Fontan circulation nas recruited to participate in neurodevelopmental testing, behavioral evaluation, and imaging of the central nervous system. The Wechsler Intelligence test was the primary measure of NDO. Analysis included comparison of patients with HLHS with other patients with functional single ventricles. Other potential clinical predictors of NDO were investigated.Results: The mean Full Scale Wechsler Intelligence score was 101.4 +/- 5.4. For the HLHS subgroup the mean Full Scale Wechsler score was 93.8 +/- 7.3, and for the non-HLHS subgroup it was 107.0 +/- 7.0. Although the HLHS group had significantly lower scores than the non-HLHS subgroup, neither subgroup scored significantly different from the standard population on the Wechsler Scares. Socioeconomic status, circulatory arrest, and perioperative seizures also were predictive of neurodevelopmental outcome.Conclusion: Neurodevelopmental and behavioral outcome in patients who have undergone the Fontan procedure including patients with HLHS is good in the preschool and early school years, with Wechsler Intelligence scores generally in the normal range.