PATTERNS OF DEVELOPMENTAL DYSFUNCTION AFTER SURGERY DURING INFANCY TOCORRECT TRANSPOSITION OF THE GREAT-ARTERIES

A randomized clinical trial was conducted to compare the early develop ment of children with d-transposition of the great arteries (N = 171) repaired by an arterial switch operation that used either predominantl y total circulatory arrest or predominantly continuous low-flow cardio pulmonary bypass. The children assigned to the circulatory arrest grou p scored lower than those assigned to low-flow bypass on the Bayley Sc ales of Infant Development at 1 year of age. Responses to parental que stionnaires completed when the children were 2.5 years old indicated t hat the children in the circulatory arrest group, especially those wit h a ventricular septal defect, also manifested poorer expressive langu age and were considered to display more internalizing and externalizin g problem behaviors. The use of circulatory arrest to protect vital or gans during open heart surgery might place children at increased risk of early developmental difficulties, especially in the domains of moto r and language function.