Navigation Links
Special Bypass Procedure Used During Infant Heart Surgery Does Not Impair Later Neurological Outcomes in Children

PHILADELPHIA, Jan. 25 /PRNewswire-USNewswire/ -- Congenital heart defects (CHD) are the most common birth defects in humans, affecting 8 per 1000 live births with one third of affected children requiring intervention in early infancy. Increasing numbers of survivors combined with developmental expectations for independence, behavioral self-regulation and academic achievement have led to a growing identification of neurobehavioral symptoms in some survivors. A study now suggests that a cooling technique often used in heart operations does not impair neurological outcomes.

Congenital heart disease and its treatment were originally thought to potentially increase neurologic injury in these patients. The technique of deep hypothermic circulatory arrest (DHCA) is used in order to repair these congenital cardiac defects by providing a bloodless surgical field, which may facilitate completion of the best physiologic repair, and decrease the duration of blood exposure to the bypass circuit. However, it involves a period of reduced blood flow in the brain. Cooling is a protective mechanism to reduce metabolism of the brain and other organs during periods of low blood flow.

Stephanie Fuller, M.D., a cardiothoracic surgeon at The Children's Hospital of Philadelphia, presented these research findings today in the prestigious J. Maxwell Chamberlain Lecture at the annual meeting of the Society of Thoracic Surgeons in Fort Lauderdale, Fla. According to the study, DHCA does not impair language skills, attention, and other neurocognitive abilities in school-age children.

Dr. Fuller and colleagues from Children's Hospital and the University of Washington assessed the use of DHCA as a predictor of neurodevelopmental outcomes in children who had cardiac surgery as infants. The infants were enrolled in a prospective study of apolipoprotein-E (APOE) polymorphisms and neurodevelopmental outcome after cardiac surgery and underwent formal neurodevelopmental testing at four years of age.

Neurodevelopmental testing was completed in 238 out of 307 eligible patients. The surgeons used DHCA in 92 of those infants as deemed necessary to provide better operative exposure with a bloodless and less cluttered surgical field and therefore a shorter total cardiopulmonary support time.  Use of DHCA was not predictive of worse performance for any neurodevelopmental outcome. Significant predictors of worse outcome included lower socioeconomic status, preoperative mechanical ventilation and babies that were younger and smaller at the time of first operation. Neurodevelopmental assessment included cognition, language skills, attention, impulsivity, executive function, social competence, and visual-motor and fine-motor skills.

"Selective use of DHCA during cardiac surgery in infancy may facilitate operative repair and is not associated with impaired neurodevelopmental outcomes," said Dr. Fuller. "Despite added risk factors, the selective use of DHCA during infancy for repair of congenital heart disease without an obstruction in the aorta was not predictive of worse performance at four years of age."

Dr. Fuller added, "use of DHCA as a support technique during cardiac surgery in infancy has many advantages, it is not necessary to sacrifice these advantages merely to avoid use of DHCA. Our study adds to the growing literature showing no adverse influence of limited periods of DHCA. New support techniques must be carefully evaluated prior to wide-spread acceptance to confirm they are not inferior to conventional management strategies."

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 441-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit  

SOURCE The Children's Hospital of Philadelphia



SOURCE The Children's Hospital of Philadelphia
Copyright©2010 PR Newswire.
All rights reserved

Related medicine news :

1. Park Avenue Podiatric Care Opens New Office in Staten Island Specializing in Cosmetic Foot Surgery
2. Dental Website Specialist, Officite, Unleashes New Online Tool For Easy Website Editing
3. Southridge Funds Facilitate Special Capital Distribution for Technest Shareholders
4. Smart Balance to Hold Special Meeting of Stockholders on January 21, 2010
5. Advanced Foot and Ankle Specialists Improves Efficiency, Workflow With Aprima Electronic Health Record
6. NUCRYST Announces Distribution of Supplemental Information In Connection with Special Meeting of Shareholders
7. Cogdell Spencer ERDMAN(SM) Announces Grand Opening of The Woodlands Center for Specialized Medicine in Pensacola, Florida
8. Americans for Responsible Health Care Launch Ad Campaign in Massachusetts Senate Special Election Campaign
9. Hard To Treat Diseases (HTDS) To Disperse Special One Time Hiru (HIRU) Common Stock
10. NUCRYST Announces Further Adjournment of Special Shareholder Meeting
11. Childrens Hospital Brings Hope to Special Babies and Their Families
Post Your Comments:
(Date:11/26/2015)... ... November 26, 2015 , ... ... eReferral system for diagnostic imaging in the Waterloo region. Using the Ocean Platform, ... Medicine tests directly from their electronic medical record (EMR) without the need for ...
(Date:11/26/2015)... ... , ... Jobs in hospital medical laboratories and in the imaging field lead ... Aureus Medical Group . These fields, as well as travel nursing, ... healthcare jobs through the company’s website, , The leading healthcare staffing ...
(Date:11/26/2015)... , ... November 26, 2015 , ... ... set of retro-fused, self-animating trailer titles with ProTrailer: Vintage. This newly styled ProTrailer ... classically-influenced trailer titles work with any font, giving users limitless opportunities to stylize ...
(Date:11/25/2015)... ... November 25, 2015 , ... Additional breast cancers found ... mammography, according to a study published online in the journal Radiology. Researchers said ... may necessitate a change in treatment. , Breast MRI is the most sensitive ...
(Date:11/25/2015)... ... November 25, 2015 , ... Finnleo, a leader in ... on several models of traditional and far-infrared saunas. , For traditional saunas, ... the most traditional Finnish sauna wood, and Finnleo uses only European Grade A Nordic ...
Breaking Medicine News(10 mins):
(Date:11/27/2015)... 26, 2015 ... the "2016 Global Tumor Marker Testing ... and Sales Segment Forecasts, Innovative Technologies, Instrumentation ... to their offering. --> ... "2016 Global Tumor Marker Testing Market: ...
(Date:11/26/2015)... Bajos, November 26, 2015 Un ... de Bremachlorin para el cáncer avanzado.   ... la terapia fotodinámica de Bremachlorin para el cáncer avanzado. ... combina la inmunoterapia con la terapia fotodinámica de Bremachlorin ... Cancer Research . --> Clinical Cancer Research ...
(Date:11/26/2015)... UTRECHT, the Netherlands , November 26, 2015 /PRNewswire/ ...   A new combination approach blends immunotherapy ... --> A new combination approach blends immunotherapy with ... A new combination approach blends immunotherapy with ... the Netherlands has found that immunotherapy ...
Breaking Medicine Technology: