{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T10:56:13Z","timestamp":1793444173660,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1999,8,3]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014It is not known whether developmental and neurological outcomes in the preschool period differ depending on whether the predominant vital organ support strategy used in infant heart surgery was total circulatory arrest (CA) or low-flow cardiopulmonary bypass.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    \u2014Infants with D-transposition of the great arteries who underwent an arterial-switch operation were randomly assigned to a support method consisting predominantly of CA or low-flow cardiopulmonary bypass. Developmental and neurological status were evaluated blindly at 4 years of age in 158 of 163 eligible children (97%). Neither IQ scores nor overall neurological status were significantly associated with either treatment group or duration of CA. The CA group scored lower on tests of motor function (gross motor,\n                    <jats:italic>P<\/jats:italic>\n                    =0.01; fine motor,\n                    <jats:italic>P<\/jats:italic>\n                    =0.03) and had more severe speech abnormalities (oromotor apraxia,\n                    <jats:italic>P<\/jats:italic>\n                    =0.007). Seizures in the perioperative period, detected either clinically or by continuous electroencephalographic monitoring, were associated with lower mean IQ scores (12.6 and 7.7 points, respectively) and increased risk of neurological abnormalities (odds ratios, 8.4 and 5.6, respectively). The performance of the full cohort was below expectations in several domains, including IQ, expressive language, visual-motor integration, motor function, and oromotor control.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014Use of CA to support vital organs during open heart surgery in infancy is associated, at the age of 4 years, with worse motor coordination and planning but not with lower IQ or with worse overall neurological status.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.100.5.526","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:42:29Z","timestamp":1339447349000},"page":"526-532","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":505,"title":["Developmental and Neurological Status of Children at 4 Years of Age After Heart Surgery With Hypothermic Circulatory Arrest or Low-Flow Cardiopulmonary Bypass"],"prefix":"10.1161","volume":"100","author":[{"given":"David C.","family":"Bellinger","sequence":"first","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wypij","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl C. K.","family":"Kuban","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard A.","family":"Rappaport","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Hickey","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Wernovsky","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Jonas","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane W.","family":"Newburger","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.C.B., K.C.K.K.), Medicine (L.A.R.), Anesthesia (P.R.H.), Cardiology (G.W., J.W.N), and Cardiovascular Surgery (R.A.J.), Children\u2019s Hospital; the Departments of Neurology (D.C.B, K.C.K.K.), Pediatrics (L.A.R., G.W., J.W.N.), Anesthesia (P.R.H.), and Surgery (R.A.J.), Harvard Medical School; and the Department of Biostatistics (D.W.), Harvard School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"309","volume":"141","year":"1987","unstructured":"Ferry PC. 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Just pretend: participation in symbolic talk by children with histories of early corrective heart surgery. Applied Psycholinguistics. In press."},{"key":"e_1_3_2_38_2","first-page":"492","volume":"32","year":"1998","unstructured":"Goldmuntz E, Clark BJ, Mitchell LE, Jawad AF, Cuneo BF, Reed L, McDonald-McGinn D, Chien P, Feuer J, Zackai EH, Emanuel BS, Driscoll DA. Frequency of 22q11 deletions in patients with conotruncal defects. Pediatr Cardiol. 1998;32:492\u2013498.The developmental and neurological morbidities associated with the vital organ support techniques of total circulatory arrest and low-flow bypass were compared in a prospective, single-center, randomized trial. At the age of 4 years, treatment groups did not differ in terms of IQ or neurological status. The circulatory arrest group scored significantly worse than the low-flow group on tests of gross, fine, and oromotor (speech) function. Use of total circulatory arrest to support vital organs during infant heart surgery is associated with a greater risk of later neurodevelopmental abnormalities than is low-flow bypass.","journal-title":"Pediatr Cardiol"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.100.5.526","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T09:06:20Z","timestamp":1715504780000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.100.5.526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,8,3]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1999,8,3]]}},"alternative-id":["10.1161\/01.CIR.100.5.526"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.100.5.526","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,8,3]]},"assertion":[{"value":"1999-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-05-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-08-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}