Early Results of Neurodevelopment Following Hybrid Stage I for Hypoplastic Left Heart Syndrome

• Published in: Pediatric cardiology Vol. 36; no. 3; pp. 685 - 691
• Main Authors: Cheatham, Sharon L., Carey, Helen, Chisolm, Joanne L., Heathcock, Jill C., Steward, Deborah
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.03.2015; Springer
• Subjects: Book publishing; Cardiac Surgery; Cardiology; Child Development; Child Language; Cognition; Comparative analysis; Female; Humans; Hypoplastic left heart syndrome; Hypoplastic Left Heart Syndrome - physiopathology; Hypoplastic Left Heart Syndrome - psychology; Hypoplastic Left Heart Syndrome - surgery; Infant; Infants; Male; Medicine; Medicine & Public Health; Motor Skills; Neuropsychological Tests; Original Article; Palliative Care - methods; Rankings; Time Factors; Treatment Outcome; Vascular Surgery; Canada; United States; Neurodevelopment; Hybrid; Congenital heart disease; Hypoplastic left heart syndrome
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-014-1065-5

Motor skills and neurodevelopment in infants with hypoplastic left heart syndrome (HLHS) who have undergone Hybrid Stage I palliation is unknown. The purpose of this study is to assess early neurodevelopment in infants with HLHS after Hybrid Stage I palliation. Developmental assessment was performed in HLHS infants who underwent Hybrid Stage I palliation at 2 and 4 months of age using the Test of Infant Motor Performance, and at 6 months of age, prior to undergoing the second staged surgery, using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Results were compared to healthy control subjects and norm-referenced data. The HLHS group scored between −1 and −2 standard deviations (SD) below the mean at 2 months of age ( p  = 0.002), and within −1 SD of the mean, at 4 months of age ( p  = 0.0019), on the TIMP. Compared to the control group, composite motor skills were significantly lower at 6 months of age on the Bayley-III in the HLHS group ( p  = 0.0489), however, not significant for cognitive ( p  = 0.29) or language ( p  = 0.68). Percentile rank motor scores were 17 ± 20 % in the HLHS group compared to 85 ± 12 % for the healthy age-matched control group. Infants with HLHS who undergo Hybrid Stage I palliation score lower on standardized motor skill tests compared to healthy age-matched controls and the norm-referenced population. This suggests that infants with HLHS have poorer motor skill performance than typically developing infants at 6 months of age.