Functional outcomes after neonatal open cardiac surgery: Comparison of survivors of the Norwood staged procedure and the arterial switch operation

Gwen Y. Alton, Gwen R. Rempel, Charlene M.T. Robertson, Christine V. Newburn-Cook, Colleen M. Norris

    Research output: Contribution to journalJournal Articlepeer-review

    16 Citations (Scopus)

    Abstract

    Background: Improvements in long-term survival of children undergoing the Norwood staged procedure and the arterial switch operation have resulted in the need to prepare these at-risk children for each stage of their developmental trajectory, including school readiness. This study describes and compares functional outcomes following the Norwood staged procedure and arterial switch operations.Methods This prospective inception cohort study comprised a sample of 73 children (71% boys) who had the Norwood staged procedure (n = 28) or the arterial switch operation (n = 45) at the age of 6 weeks or younger at the Stollery Childrens Hospital, Edmonton, Alberta, between 2002 and 2005. We excluded children who had chromosomal abnormalities or cerebral palsy. When children were 18-24 months of age, parents completed the Adaptive Behavioral Assessment System II. Standard scores for the domains are mean 100, standard deviation (15); skill area scaled scores, 10 (3). Students t-test with Bonferonni correction was used to compare groups.Results This population has greater than four times the number of children delayed on the General Adaptive Composite than the normative group. Functional outcomes were similar in the two groups other than those of home living (Norwood: 8.8 (2.8) compared with arterial switch: 11.2 (3.1), t = 3.389, p = 0.001) and self-care (Norwood: 5.9 (3.5) versus arterial switch: 8.1 (2.6), t = 3.140, p = 0.002).Conclusion These survivors are at increased risk for delayed functional abilities. Self-care, necessary for independence and confidence as children reach school age, was particularly low in the Norwood group. Reasons for low self-care abilities require further study.

    Original languageEnglish
    Pages (from-to)668-675
    Number of pages8
    JournalCardiology in the Young
    Volume20
    Issue number6
    DOIs
    Publication statusPublished - Dec. 2010

    Keywords

    • Congenital cardiac disease
    • adaptive behaviour
    • early childhood development
    • functional outcomes
    • hypoplastic left heart syndrome
    • transposition of the great arteries

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