S. Bernheim, E. Saarda, M. Hully, C.J. Roux, M. Kossorotof, F. Bajolle, D. Bonnet, O. Raisky
{"title":"心脏手术后的异常运动：一系列小儿心脏泵术后舞蹈症","authors":"S. Bernheim, E. Saarda, M. Hully, C.J. Roux, M. Kossorotof, F. Bajolle, D. Bonnet, O. Raisky","doi":"10.1016/j.acvd.2024.07.033","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Neurological disorders following heart surgery are mainly attributable to strokes. However there is a rare cause of abnormal movement following heart surgery: post-pump chorea. This complication is rare and poorly described particularly with regard to its therapeutic management and evolution.</p></div><div><h3>Methods</h3><p>Descriptive monocentric retrospective study including all children with post-pump chorea over a 10-year period (2014–2023). Clinical presentation, radiological findings, and outcomes were analyzed based on clinical, biological, and cerebral imaging data.</p></div><div><h3>Results</h3><p>Over 10<!--> <!-->years, 7059 pediatric cardiac surgeries with cardiopulmonary bypass (CBP) were performed at Necker hospital, and 11 patients experienced post-pump chorea (0.15%), including 5 boys (45%). Median age at the diagnosis of post-pump chorea was 5.7<!--> <!-->years [0.45–9.9]. One patient was premature, and none had genetic syndromes. Median BMI was low (14.8 [11.9–17.4]). Six patients had cyanotic heart disease. Six patients (55%) had previously undergone surgery with CBP. Median CBP duration and length of stay in the intensive care unit were typical, at 132<!--> <!-->minutes [64–362] and 6<!--> <!-->days [1–186], respectively. The interval between surgery and symptom onset was 20<!--> <!-->days [4–64], with a median duration of 44<!--> <!-->days [3–181]. Abnormal movements primarily affected the face (100%) and were often bilateral (82%), involving the upper limbs (91%) and lower limbs (82%). Initial cerebral MRI did not show recent ischemic lesions. Six patients (55%) received medical treatment: tetrabenazine (<em>n</em> <!-->=<!--> <!-->2), intravenous immunoglobulins (<em>n</em> <!-->=<!--> <!-->1), corticosteroids (<em>n</em> <!-->=<!--> <!-->1), L-Dopa (<em>n</em> <!-->=<!--> <!-->1), cyamemazine (<em>n</em> <!-->=<!--> <!-->1). Chorea persisted beyond 6 months in only 1 out of 11 patients.</p></div><div><h3>Conclusion</h3><p>Post-pump chorea is extremely rare and can occur several months after cardiac surgery. It does not appear to be directly related to perioperative severity criteria. The prognosis is generally favorable within 6<!--> <!-->months following diagnosis.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Page S234"},"PeriodicalIF":2.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Abnormal movements following heart surgery: A series of pediatric post-pump chorea\",\"authors\":\"S. Bernheim, E. Saarda, M. Hully, C.J. Roux, M. Kossorotof, F. Bajolle, D. Bonnet, O. Raisky\",\"doi\":\"10.1016/j.acvd.2024.07.033\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Neurological disorders following heart surgery are mainly attributable to strokes. However there is a rare cause of abnormal movement following heart surgery: post-pump chorea. This complication is rare and poorly described particularly with regard to its therapeutic management and evolution.</p></div><div><h3>Methods</h3><p>Descriptive monocentric retrospective study including all children with post-pump chorea over a 10-year period (2014–2023). Clinical presentation, radiological findings, and outcomes were analyzed based on clinical, biological, and cerebral imaging data.</p></div><div><h3>Results</h3><p>Over 10<!--> <!-->years, 7059 pediatric cardiac surgeries with cardiopulmonary bypass (CBP) were performed at Necker hospital, and 11 patients experienced post-pump chorea (0.15%), including 5 boys (45%). Median age at the diagnosis of post-pump chorea was 5.7<!--> <!-->years [0.45–9.9]. One patient was premature, and none had genetic syndromes. Median BMI was low (14.8 [11.9–17.4]). Six patients had cyanotic heart disease. Six patients (55%) had previously undergone surgery with CBP. Median CBP duration and length of stay in the intensive care unit were typical, at 132<!--> <!-->minutes [64–362] and 6<!--> <!-->days [1–186], respectively. The interval between surgery and symptom onset was 20<!--> <!-->days [4–64], with a median duration of 44<!--> <!-->days [3–181]. Abnormal movements primarily affected the face (100%) and were often bilateral (82%), involving the upper limbs (91%) and lower limbs (82%). Initial cerebral MRI did not show recent ischemic lesions. Six patients (55%) received medical treatment: tetrabenazine (<em>n</em> <!-->=<!--> <!-->2), intravenous immunoglobulins (<em>n</em> <!-->=<!--> <!-->1), corticosteroids (<em>n</em> <!-->=<!--> <!-->1), L-Dopa (<em>n</em> <!-->=<!--> <!-->1), cyamemazine (<em>n</em> <!-->=<!--> <!-->1). Chorea persisted beyond 6 months in only 1 out of 11 patients.</p></div><div><h3>Conclusion</h3><p>Post-pump chorea is extremely rare and can occur several months after cardiac surgery. It does not appear to be directly related to perioperative severity criteria. The prognosis is generally favorable within 6<!--> <!-->months following diagnosis.</p></div>\",\"PeriodicalId\":55472,\"journal\":{\"name\":\"Archives of Cardiovascular Diseases\",\"volume\":\"117 8\",\"pages\":\"Page S234\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Cardiovascular Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1875213624002547\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1875213624002547","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Abnormal movements following heart surgery: A series of pediatric post-pump chorea
Introduction
Neurological disorders following heart surgery are mainly attributable to strokes. However there is a rare cause of abnormal movement following heart surgery: post-pump chorea. This complication is rare and poorly described particularly with regard to its therapeutic management and evolution.
Methods
Descriptive monocentric retrospective study including all children with post-pump chorea over a 10-year period (2014–2023). Clinical presentation, radiological findings, and outcomes were analyzed based on clinical, biological, and cerebral imaging data.
Results
Over 10 years, 7059 pediatric cardiac surgeries with cardiopulmonary bypass (CBP) were performed at Necker hospital, and 11 patients experienced post-pump chorea (0.15%), including 5 boys (45%). Median age at the diagnosis of post-pump chorea was 5.7 years [0.45–9.9]. One patient was premature, and none had genetic syndromes. Median BMI was low (14.8 [11.9–17.4]). Six patients had cyanotic heart disease. Six patients (55%) had previously undergone surgery with CBP. Median CBP duration and length of stay in the intensive care unit were typical, at 132 minutes [64–362] and 6 days [1–186], respectively. The interval between surgery and symptom onset was 20 days [4–64], with a median duration of 44 days [3–181]. Abnormal movements primarily affected the face (100%) and were often bilateral (82%), involving the upper limbs (91%) and lower limbs (82%). Initial cerebral MRI did not show recent ischemic lesions. Six patients (55%) received medical treatment: tetrabenazine (n = 2), intravenous immunoglobulins (n = 1), corticosteroids (n = 1), L-Dopa (n = 1), cyamemazine (n = 1). Chorea persisted beyond 6 months in only 1 out of 11 patients.
Conclusion
Post-pump chorea is extremely rare and can occur several months after cardiac surgery. It does not appear to be directly related to perioperative severity criteria. The prognosis is generally favorable within 6 months following diagnosis.
期刊介绍：
The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
