The effect of preoperative balloon atrial septostomy and intraoperative parameters on neurodevelopmental scoring in neonates operated for transposition of the great artery.

IF 0.5 4区 医学 Q4 SURGERY
Yiğit Kılıç, Şenay Güven Baysal, Özlem Gül, Bedri Aldudak
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引用次数: 0

Abstract

Background: The aim of this study was to investigate the effect of preoperative balloon atrial septostomy and intraoperative parameters on neurodevelopmental outcomes in neonates operated for transposition of the great arteries.

Methods: Between February 2018 and March 2022, a total of 60 patients (49 male, 11 female; mean age, 23.5±8.8 days; range, 2 to 106 days) who were operated with a diagnosis of simple transposition of the great arteries and discharged uneventfully were included. Preoperative balloon atrial septostomy was performed in 33 patients (BAS+ group), while 27 patients (BAS- group) did not undergo the procedure. Finally, 13 patients from the septostomy group and 12 patients from the non-septostomy group were available for follow-up. Neurodevelopment in infants was assessed using the 3rd edition of the Bayley Scales of Infant and Toddler Development (Bayley-III) scoring.

Results: The mean cognitive, language, and motor composite scores were 85.00±11.73, 89.62±12.29, and 83.38±14.83 in the BAS+ group and 94.58±18.40, 99.83±15.71, and 90.00±18.73 in the BAS- group, respectively (p=0.131, p=0.123, and p=0.689, respectively). Ballon atrial septostomy was the only factor that caused a decrease in all composite scores according to Bayley-III scoring, although not statistically significant. There was a significant negative correlation between C-reactive protein and all composite scores. There was also a significant negative correlation between cardiopulmonary bypass time, cross-clamping time, mean plasma lactate levels (mmol/L) on postoperative Days 2-5, postoperative creatinine, and motor composite scores. There was a significant positive correlation between growth weight and head circumference and all three CSs.

Conclusion: Ballon atrial septostomy may adversely affect the neurodevelopmental process in neonates. We believe that close monitoring of postoperative blood values such as lactate, C-reactive protein and creatinine, and avoiding hypoxemia and keeping them at optimal levels are crucial. Good weight gain can also contribute to the neurodevelopment of patients.

术前球囊房间隔造口术及术中参数对大动脉转位新生儿神经发育评分的影响。
背景:本研究的目的是探讨术前球囊房间隔造口术和术中参数对大动脉转位新生儿神经发育结局的影响。方法:2018年2月至2022年3月,共60例患者(男49例,女11例;平均年龄23.5±8.8天;范围,2至106天),诊断为单纯性大动脉转位并顺利出院的患者包括在内。33例患者(BAS+组)行房间隔气囊造口术,27例患者(BAS-组)未行气囊造口术。最后,中隔造瘘组13例,非中隔造瘘组12例。使用第三版贝利婴幼儿发育量表(Bayley- iii)评分来评估婴儿的神经发育。结果:BAS+组认知、语言、运动综合评分平均分别为85.00±11.73、89.62±12.29、83.38±14.83,BAS-组平均分别为94.58±18.40、99.83±15.71、90.00±18.73 (p=0.131、p=0.123、p=0.689)。根据Bayley-III评分,球囊房间隔造口术是导致所有综合评分下降的唯一因素,但无统计学意义。c反应蛋白与各综合评分呈显著负相关。体外循环时间、交叉夹持时间、术后2-5天平均血浆乳酸水平(mmol/L)、术后肌酐和运动综合评分也存在显著负相关。生长重、头围与3种CSs均呈显著正相关。结论:球囊式房间隔造口术可能对新生儿神经发育过程产生不利影响。我们认为密切监测术后血液值,如乳酸、c反应蛋白和肌酐,避免低氧血症并将其保持在最佳水平是至关重要的。良好的增重也有助于患者的神经发育。
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来源期刊
CiteScore
1.00
自引率
0.00%
发文量
98
审稿时长
3-8 weeks
期刊介绍: The Turkish Journal of Thoracic and Cardiovascular Surgery is an international open access journal which publishes original articles on topics in generality of Cardiac, Thoracic, Arterial, Venous, Lymphatic Disorders and their managements. These encompass all relevant clinical, surgical and experimental studies, editorials, current and collective reviews, technical know-how papers, case reports, interesting images, How to Do It papers, correspondences, and commentaries.
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