Original ArticleImpact of Prenatal Diagnosis on Neurocognitive Outcomes in Children with Transposition of the Great Arteries
Section snippets
Methods
All children born with a TGA between 2003 and 2005 were screened for enrollment in a single-center prospective study of neurocognitive outcomes conducted at Necker Children’s Hospital (Paris, France). Eligibility criteria included a diagnosis of TGA with intact ventricular septum or ventricular septal defect (VSD) in children who underwent a neonatal arterial switch operation with a single method of vital organ support (continuous full-flow cardiopulmonary bypass grafting). Exclusion criteria
Results
Sixty eligible children were identified in the database. Parents of 6 children declined to participate in the study, and two children were excluded because of developmental disorders not previously identified (autism spectrum disorder and severe language disability). Six families could not be contacted because of a change of address, and one child refused to cooperate with the administration of the tests. Therefore, 45 eligible children (75%) participated in the study. No significant
Discussion
Neurocognitive deficits in children with a d-TGA after surgical correction continue to be reported despite great progress in surgical management. Children with ductal-dependent lesions are at risk of ductal closure and therefore at high risk of acidosis, hypoxemia, and hypoxic-ischemic injury.18 Several studies have demonstrated an association between prenatal diagnosis of congenital heart disease (CHD), including TGA, and a significant decrease in preoperative morbidity.2, 3, 19 It has been
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Emergency arterial switch: Rescue therapy for life-threatening hypoxemia in infants with transposition of great arteries with intact intraventricular septum
2023, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Nevertheless, the median age at admission was similar to that in the nonemergency group whereas the age at operation tended to be younger reflecting the time frame of PPHN. We have previously reported that infants with transposition of the great arteries who are not diagnosed prenatally or are born at a distance from the surgical center are especially at risk of death without surgery,23 and the outcome benefits of an antenatal diagnosis are well described.24,25 Early postnatal diagnoses might allow prompt management, whereas later postnatal diagnoses, often after representation from home, might require intensive resuscitation.
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Supported by the association for research in cardiology from Foetus to Adults (Association pour la Recherche en Cardiologie du Foetus à l’Adulte), Necker Children’s Hospital, Paris, France. The authors declare no conflicts of interest.