Attentional symptoms, preoperative oxygenation and quality of life after arterial switch repair of D-transposition of the great arteries - Scorecard - MDSpire
Clinical Scorecard: Attention-Related Symptoms, Preoperative Oxygenation, and Quality of Life Following Arterial Switch Repair for D-Transposition of the Great Arteries
At a Glance
Category
Detail
Condition
Neurodevelopmental and quality-of-life outcomes after arterial switch repair for D-transposition of the great arteries (D-TGA)
Key Mechanisms
The study examined associations among parent-reported behavioural symptoms, preoperative pre-ductal oxygen saturation, cognition, and health-related quality of life; it did not establish causal mechanisms.
Target Population
Children aged 4–18 years with repaired D-TGA
Care Setting
Long-term follow-up after congenital heart surgery; evidence comes from a single-centre exploratory study in Thailand.
Key Highlights
In 24 children, parent-reported inattention and peer-relationship problems were inversely associated with total PedsQL scores; prosocial behaviour was positively associated.
KBIT-2 composite IQ had a weak, non-significant association with total PedsQL and did not differ significantly between IQ groups below and at or above 90.
Preoperative pre-ductal SpO₂ was associated with IQ after adjustment for mode of delivery (B 0.94 per 1% SpO₂; 95% CI 0.28–1.60; p=0.008).
The authors describe preoperative SpO₂ as a candidate physiological marker, not a causal exposure, and advise cautious interpretation.
The study was limited by its small single-centre sample, cross-sectional design, retrospective SpO₂ data, parent-reported outcomes, and lack of multiple-testing correction.
Guideline-Based Recommendations
Diagnosis
The 2024 American Heart Association statement recommends structured neurodevelopmental surveillance throughout childhood after congenital heart disease.
Management
The authors state that brief parent-reported screening of attention and peer functioning may complement cognitive assessment during long-term follow-up, particularly when formal neuropsychological testing cannot be performed at every visit.
Monitoring & Follow-up
Assess neurodevelopment throughout childhood following congenital heart disease, consistent with the cited 2024 American Heart Association statement.
Consider parent-reported attention and peer-functioning measures alongside cognitive assessment during follow-up after D-TGA repair.
Risks
Neurodevelopmental consequences after arterial switch repair for D-TGA are established; early developmental or IQ measurements may not forecast later outcomes.
The study's associations cannot establish causality, and its small sample and multiple uncorrected comparisons limit interpretation.
Patient & Prescribing Data
Single-centre exploratory cross-sectional cohort of 24 children aged 4–18 years with repaired D-TGA; all had undergone arterial switch operation.
No medication or treatment intervention was evaluated. The study assessed behavioural symptoms, cognition, preoperative oxygen saturation, and quality of life after repair.
Clinical Best Practices
Use structured neurodevelopmental surveillance throughout childhood after congenital heart disease, as recommended by the cited AHA statement.
In follow-up after D-TGA repair, parent-reported attention and peer-functioning screening may complement global cognitive assessment.
Interpret associations involving a retrospectively abstracted single preoperative SpO₂ measurement cautiously; the study does not establish causation.
Adults assigned to nonnutritive sweetened beverages or water maintained weight reductions through 104 weeks, with no statistically significant difference between groups.
A randomized cardiac surgery trial found noninferior bleeding control with refrigerated platelets, although reexploration rates and blood product requirements were higher.
