Neurodevelopmental outcomes in preschool survivors of the Fontan procedure.
Neurodevelopmental outcomes in preschool survivors of the Fontan procedure.
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DOI：
10.1016/j.jtcvs.2013.12.019
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发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Spray TL
中科院分区：
文献类型：
--
作者：
Gaynor JW;Ittenbach RF;Gerdes M;Bernbaum J;Clancy RR;McDonald-McGinn DM;Zackai EH;Wernovsky G;Nicolson SC;Spray TL
比较Fontan手术的学龄前幸存者与接受双心室（BV）修复的先天性心脏病（CHD）儿童的神经发育（ND）结局，并研究单心室（SV）CHD患者ND结局的预测因素，包括左心发育不良综合征（HLHS）。在4岁时评估ND结果，包括认知，视觉-运动整合，行为，社交技能和学业成绩。比较BV和SV患者的未校正结局。在SV患者中评估ND结局的预测因素。使用患者相关、手术和术后协变量评价多协变量模型。在365名儿童中进行了ND评价，其中112名在Fontan术后[HLHS（n = 91），其他SV（n = 21）]，253名在BV修复术后。与BV患者相比，SV患者在处理速度、注意力不集中和冲动性方面表现较差。除此之外，各组之间在任何领域均无显著差异。SV患者在视觉运动整合方面的表现有降低的趋势。HLHS患者的结局并不比其他形式的功能性SV差。患者因素是ND结局的更重要的预测因子，而不是手术治疗变量。在该队列中，Fontan手术的学龄前幸存者的未校正ND结局与接受BV修复术的CHD儿童的结局在大多数领域相似。在Fontan患者中，与其他形式的SV相比，HLHS与更差的结局无关。
To compare neurodevelopmental (ND) outcomes of preschool survivors of the Fontan procedure with those of children with congenital heart disease (CHD) undergoing biventricular (BV) repair and to investigate predictors of ND outcome for those with single ventricle (SV) CHD, including hypoplastic left heart syndrome (HLHS). ND outcomes were assessed at 4 years of age including cognition, visual-motor integration, behavior, social skills and academic achievement. Unadjusted outcomes were compared between the BV and SV patients. Predictors of ND outcome were assessed in the SV patients. Multiple-covariate models were evaluated using patient-related, operative, and post-operative covariates. ND evaluation was performed in 365 children, 112 after the Fontan [HLHS (n = 91), other SV (n = 21)] and 253 after BV repair. Compared to BV patients, the SV patients performed worse in terms of processing speed, inattention and impulsivity. Otherwise there were no significant differences between the groups for any domain. There was a trend toward lower performance for SV patients on visual motor integration. Outcomes for patients with HLHS were not worse than for other forms of functional SV. Patient factors were more important predictors of ND outcomes than were operative management variables. In this cohort, unadjusted ND outcomes for preschool survivors of the Fontan procedure are similar to those for children with CHD undergoing BV repair for most domains. Among the Fontan patients, HLHS was not associated with worse outcomes compared to other forms of SV.
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DOI：
10.1016/j.jtcvs.2010.07.069
发表时间：
2010-12-01
影响因子：
6
作者：
Gaynor, J. William;Gerdes, Marsha;Jarvik, Gail P.
通讯作者：
Jarvik, Gail P.
影响因子：
8
作者：
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通讯作者：
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DOI：
10.1016/j.pedhc.2006.03.008
发表时间：
2007-01-01
期刊：
Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
影响因子：
--
作者：
Brosig, Cheryl L;Mussatto, Kathleen A;Tweddell, James S
通讯作者：
Tweddell, James S
影响因子：
24
作者：
Feinstein, Jeffrey A.;Benson, D. Woodrow;Martin, Gerard R.
通讯作者：
Martin, Gerard R.
影响因子：
5.1
作者：
Goldberg, CS;Schwartz, EM;Kulik, TJ
通讯作者：
Kulik, TJ