Boston - American Association for Thoracic Surgery

AMERICAN ASSOCIATION FOR THORACIC SURGERYMONDAY AFTERNOONMAY 11, 20092:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION –CONGENITAL HEART DISEASERoom 312, Hynes Convention Center(8 minutes presentation, 12 minutes discussion)Moderators: James S. TweddellVaughn A. Starnes22. Is Cardiac Diagnosis a Predictor of Neurodevelopmental OutcomeAfter Cardiac Surgery in Infancy?J.W. Gaynor, 1* Marsha Gerdes, 1 Alex S. Nord, 2 Judy Bernbaum, 1 Elaine H. Zackai, 1Gil Wernovsky, 1 Robert R. Clancy, 1 Patrick J. Heagerty, 2 Cynthia B. Solot, 1Jo Ann D’Agostino, 1 Nancy B. Burnham, 1 Donna McDonald-McGinn, 1Susan C. Nicolson, 1 Thomas L. Spray, 1* Gail P. Jarvik 21. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 2. University ofWashington, Seattle, WA, USAInvited Discussant: Ivan M. RebeykaMONDAYAfternoonOBJECTIVE: To determine if cardiac diagnosis is a predictor of neurodevelopmental(ND) outcomes after infant cardiac surgery.METHODS: Infants with ventricular septal defect (VSD), tetralogy of Fallot(TOF), transposition of the great arteries (TGA) and hypoplastic left heart syndrome(HLHS) in a study of apolipoprotein E (APOE) polymorphisms and NDoutcome underwent ND and genetic evaluation at 4 years of age. Domains testedincluded: cognition; language; speech; memory; executive function; visual-motor,fine motor and academic skills.RESULTS: Testing was completed in 178 patients with normal genetic evaluations:VSD (26), TOF (44), TGA (41) and HLHS (67). There were no differences in gestationalage, ethnicity, APOE genotype, socioeconomic status or maternal educationamong groups. Age at first operation was significantly lower for patients with TGAand HLHS compared to TOF and VSD. Post-operative length of stay (LOS) was significantlylonger for HLHS compared to all other groups and for TGA compared toTOF and VSD. HLHS was significantly correlated with use of deep hypothermiccirculatory arrest (DHCA) and multiple operations. Mean scores for each domainwere within normal limits for all groups. (Figure) Compared to HLHS, patients* AATS Member109