Navigation Links
Special Bypass Procedure Used During Infant Heart Surgery Does Not Impair Later Neurological Outcomes in Children
Date:1/25/2010

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 http://www.chop.edu.  

SOURCE The Children's Hospital of Philadelphia

RELATED LINKS
http://www.chop.edu

'/>"/>

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:
*Name:
*Comment:
*Email:
(Date:4/30/2016)... ... April 30, 2016 , ... Create an abstract shape ... distort and manipulate three-dimensional shapes with ease all within Apple Motion . ... polygons, polygon texture animation, opacity texture animation, overall shape texture displacement, twist, camera ...
(Date:4/30/2016)... ... April 30, 2016 , ... The Hacking Medicine ... program to critically evaluate and rank health-focused applications and connected devices for better ... independent, unbiased and accurate information to help accelerate patient and provider adoption of ...
(Date:4/30/2016)... ... April 30, 2016 , ... Dr. Trevor Gardner, President of ... signed a multifaceted agreement which will allow for the research and development of ... Natural and Applied Sciences, Allied Health and Nursing will work together to develop ...
(Date:4/30/2016)... CA (PRWEB) , ... April 30, 2016 , ... “Aging well is a challenge for all of us, but there ... NCMA’s Dr. Parul T. Kohli . “Research is showing more and more that there are ... of disease and disability as we age.” Top priorities Dr. Kohli’s recommends for her patients include;, ...
(Date:4/29/2016)... (PRWEB) , ... April 30, 2016 , ... ... engineer of patented products, announces the Pick Up Springboard, an automotive invention that ... Light Truck Manufacturing industry is worth $162 billion," says Scott Cooper, CEO and ...
Breaking Medicine News(10 mins):
(Date:4/27/2016)... TURIN, Italy , April 27, 2016 ... MR-guided linear accelerator (MR-linac) platform will be the focal ... annual meeting of the European Society for Radiotherapy & ... Elekta,s MR-linac integrates a state-of-the-art radiotherapy system and ... a physician to clearly see the patient,s anatomy in ...
(Date:4/27/2016)... April 27, 2016 Shire plc (LSE: ... Poulton , Chief Financial Officer, will present at the Deutsche ... MA on Wednesday, May 04, 2016, 10:00 am ... be available on the Presentations and Webcasts section of Shire,s ... the webcast will be available on this same website for ...
(Date:4/27/2016)... 27, 2016 At the Sachs ... of a Phase 2 clinical study of its lead ... undergoing cochlear implantation (CI) surgery. This large, placebo-controlled, double-blind, ... Germany and France ... at the time of surgery. "Despite advances in cochlear ...
Breaking Medicine Technology: