Five-year follow-up of neonates with reconstructed right common carotid arteries after extracorporeal membrane oxygenation

Objective: Serial Doppler ultrasonography and long-term neurodevelopmental follow-up outcomes were evaluated prospectively in neonates whose right com mon carotid artery (RCCA) was reconstructed after extracorporeal membrane o xygenation (ECMO). Methods: Children with RCCA reconstruction (n = 34) were monitored for 3.5 to 4.5 years by Doppler ultrasonography for arterial patency, and 28 had IQ testing by 5 years. A comparison group consisted of 35 infants who had RCC A ligation after ECMO. Neonatal electroencephalograms and computed tomograp hy/magnetic resonance imaging scans were also compared. Results: Reconstructions were successful (<50% RCCA stenosis by Doppler ult rasonography) in 26 (76%) of 34 children, 3 (9%) had greater than or equal to 50% stenosis, and 5 (15%) had occlusion. No significant differences were seen between reconstructed and ligated groups in neonatal complications or ECMO courses. Occurrence of marked neonatal electroencephalographic abnorm alities did not differ between groups. Abnormalities on computed tomography /magnetic resonance imaging scans (4 of 31 vs 11 of 29, P = .025) and cereb ral palsy (0 of 34 vs 5 of 35, P = .054) were more common in infants with R CCA ligation. No differences were seen in developmental or IQ scores betwee n the 2 groups, and 4 in each group had cognitive handicaps (at least 1 IQ score <70). Conclusions: Most RCCA reconstructions remained patent, with 24% showing si gnificant stenosis or occlusion. Compared with a historical control group, patients with RCCA reconstruction had fewer brain scan abnormalities and te nded to be less likely to have cerebral palsy. RCCA reconstruction after ve noarterial ECMO may improve outcome.