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Of the 171 patients enrolled in the study,155 were evaluated.After adjustment for the presence of absence of a ventricular septal defect,the infants assigned to circulatory arrest,as compared with those assigned to low-flow bypass,had a lower mean score on the Psychomotor Development Index of the Bayley Scales of Infant Development(a 6.5-point deficit,P=0. 01)and a higher proportion had scores=80(i.e.,2 SD or more below the population mean)(27 percent vs.12 percent,P=0.02).The score o9n the Psychomotor Development Index was inversely related to the duration of circulatory arrest(P=0.02).The risk of neurologic abnormalities increased with the duration of circulatory arrest(P=0.04).The method of support was not associated with the prevalence of abnormalities on MRI scans of the brain,scores on the Mental Development Index of the Bayley Scale,or scores on a test of visual-recognition memory.Perioperative electroencephalographic seizure activity was associated with lower scores on the Psychomotor Development Index(P=0.002)and an increased likelihood of abnormalities on MRI scans of the brain(P<0.001).Heart surgery performed with circulatory arrest as the predominant support strategy is associated with a higher risk of delayed motor development and neurologic abnormalities at the age of one year than is surgery with low-flow bypass as the predominant support strategy. |
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cardiac surgery,hypothermia and circulatory arrest for cardiac surgery,neurologic complications with cardiopulmonary bypass developmental evaluation developmental retardation psychological testing psychological testing,children
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