Infant Heart Transplant: Perioperative Indicators of Neurocognitive Development

<p>Approximately five to eight births per 1000 in the United States are born with a congenital heart defect (Limperopoulos et al, 1999), the primary defect in 57% is hypoplastic left heart syndrome (Johnston, 1991). A fatal disease twenty years ago, survival has jumped from less than 5% to 91% of infants surviving their one-month birthday due to advances in palliative and transplant procedures (Razzouk et al, 1996). Unfortunately, the decrease in mortality has been unmatched by a decrease in morbidity, which continues to be a major risk factor when undergoing deep hypothermia (du Plessis, 2000). While neurodevelopmental and cognitive dysfunction may be related to pre-, peri-, and post-operative factors, the current study attempts to tease apart some of the perioperative factors related to intellectual outcome. The study retrospectively examined 44 infants who received cardiac transplantation between 1985 and 1990 and had also received cognitive and academic assessment between 4 to 10 years of age. Results revealed that rewarming rate and DHCA times under 40 minutes did not correlate with intellectual outcome. Conversely, cooling rate, DHCA time over 40 minutes when age was taken into account, and temperature at minimum oxygen saturation did correlate with outcome. There was also an unexpected interaction between minimum bypass flow rate and average mean arterial pressure in relation to outcome. The incidence and predictability of learning disabilities are also discussed.</p>

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Psychology

Year

2004

Author dc:creator

• Gardner, Joy Michelle

Contributors dc:contributor

• Kiti Freier
• Richard Chinnock
• Kim Freeman
• Matt Riggs
• Stanford Shu

• Cardiology
• Cognitive Psychology
• Developmental Psychology
• Health Psychology
• Pediatrics
• Psychology
• Heart Transplantation -- in infancy and childhood; Cognition; Developmental Disabilities; Heart Defects, Congenital.

Statement dc:rights

• This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Language dc:language

English

Repository record dc:identifier

https://scholarsrepository.llu.edu/etd/1533

OAI identifier oai:identifier

oai:scholarsrepository.llu.edu:etd-2310