The Japanese journal of surgery

, Volume 11, Issue 3, pp 154–161 | Cite as

Somatic and psychomotor development of children after hypothermic open-heart surgery

  • Hiroshi Shida
  • Masami Morimoto
  • Koichi Inokawa
  • Yutaka Ikeda
  • Jiro Tsugane
  • Hideki Yuzuriha
Article

Abstract

One hundred and seven patients with ventricular septal defect who survived one and a half to thirteen years after hypothermic open-heart surgery were reviewed with respect to somatic, intellectual, and psychomotor development. There were no negative effects associated with deep hypothermic arrest in any of these areas. Abnormal electroencephalograms were seen in one-half the number of patients examined, but there was no close relation between the circulatory arrest period and electroencephalographic findings. CT scanning of the brain indicated that the abnormality decreased with the lapse of the time after hypothermic open-heart surgery. It would appear that hypothermic open-heart surgery with limited circulatory arrest is a useful method, providing that the circulatory arrest is not allowed to exceed a limited period. However electroencephalographic assessment suggests that postoperative cerebral abnormalities may occur more frequently than previously suspected, despite the lack of preoperative abnormalities on the electroencephalograms.

Key words

somatic development psychomotor development ventricular septal defect hypothermia open-heart surgery 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Branthwaite, M.A.: Prevention of neurological damage during open-heart surgery. Thorax 30: 258–261, 1975.PubMedGoogle Scholar
  2. 2.
    Subramanian, S., Wagner, H., Vlad, P. and Lambert, E.: Surface-induced deep hypothermia in cardiac surgery. J. Pediat. Surg., 6: 612–617, 1971.PubMedCrossRefGoogle Scholar
  3. 3.
    Pagni, C.A. and Courjon, J.: Neurological observations during hypothermia. Acta Neurochir. Suppl. 13: 23–34, 1964.Google Scholar
  4. 4.
    Delay, J., Deniker, P., Ginester, D., Verdeaux, J. and De Traubenberg, N.R.: Neuro-psychic effects of operations with prolonged circulatory arrest under deep hypothemia. Presse Med., 69: 2539–2542, 1961.PubMedGoogle Scholar
  5. 5.
    Belsey, R.H.R., Dowlatschahi, K., Keen, G. and Skinner, D.B.: Profound hypothermia in cardiac surgery. J. Thorac. Cardiovasc. Surg., 56: 497–509, 1968.PubMedGoogle Scholar
  6. 6.
    Egerton, N., Egerton, W.S. and Kay, J.H.: Neurologic changes following profound hypothermia. Ann. Surg., 157: 366–374, 1962.CrossRefGoogle Scholar
  7. 7.
    Mori, A., and Muraoka, R.: Deep hypothermia combined with cardiopulmonary bypass for cardiac surgery in neonates and infants. J. Thorac. Cardiovasc. Surg., 64: 422–429, 1972.PubMedGoogle Scholar
  8. 8.
    Brunberg, J.A., Relly, E.L. and Doty, D.B.: Central nervous system consequences in infants of cardiac surgery using deep hypothermia and circulatory arrest. Circulation, 49, 50 (Suppl. II): 60–68, 1974.Google Scholar
  9. 9.
    Stevenson, J.G., Stone, E.F., Dillard, D.H. and Morgan, B.C.: Intellectual development of children subjected to prolonged circulatory arrest during hypothermic open-heart surgery in infancy. Circulation 49, 50 (Suppl II): 54–59, 1974.Google Scholar
  10. 10.
    Messmer, B.J., Schallberger, U., Gattiker, R. and Senning, A.: Psychomotor and intellectual development after deep hypothermia and circulatory arrest in early infancy. J. Thorac. Cardiovasc. Surg., 72: 495–502, 1976.PubMedGoogle Scholar
  11. 11.
    Wright, J.S., Hicks, R.G. and Newman, D.C.: Deep hypothermic arrest: Observations on later development in children. J. Thorac. Cardiovasc. Surg., 77: 466–468, 1979.PubMedGoogle Scholar
  12. 12.
    Okamura, H., Yonezawa, T., Seta K., Wako, H.: Experimentelle und klinische Studien bei Operationen am offenen Herzen unter Tiefer Hypothermie mit Kardioplegischen Substanzen. Langenbecks Arch Klin Chir 297: 593, 1961.CrossRefGoogle Scholar
  13. 13.
    Nishikawa, K., Niitu, K., Yasui, Y., Murai, M., Uchiyama, T., Iwabuchi, K., Oikawa, U., Inoue, H., Ara, H., Isono, T., Kumagai, U., Uchiyama, T., Wakuzawa, R., Shibata, S., Chiba, T., Saito, H., Hosoi, N., Miyamoto, A., Okada, K.: Cerebral dysfunction following open heart surgery under surface induced hypothermia. Kyobu Geka (Jpn. J. Thorac. Surg.) 24: 467–477, 1971 (with English Abst.).PubMedGoogle Scholar
  14. 14.
    Hosoi, Y., Okamura, H., Nakamura, J., Sagara, T., Matsuoka, A., Sezaki, T., Yamashita, J., Kobayashi, H., Endo, T., Katsuta, S., Kabe, T., Saito, M.: Anesthetic management of surface induced profound hypothermia for open-heart surgery, especially, management of cooling process. Kyobu Geka (Jpn. J. Thorac. Surg.) 26: 91–99, 1973.PubMedGoogle Scholar
  15. 15.
    Barratt-Boyes, B. G., Neutge, J.M., Seelye, E.R., Simpson, M.: Complete correction of cardiovascular malformation in the first year of life. Progr. Cardiovasc. Dis., 15: 229253, 1972.CrossRefGoogle Scholar
  16. 16.
    Shida, H., Morimoto, M., Inokawa, K., Tsugane, J. and Ikeda, Y.: Simple deep hypothermia for open-heart surgery. J. Cardiovasc. Surg., 20: 135–144, 1979.Google Scholar
  17. 17.
    Rittenhouse, E.A., Mohri, H., Dillard, D.H., Merendino, K.A.: Deep hypothermia in cardiovascular surgery. Ann. Thorac. Surg., 17: 63–98, 1974.PubMedCrossRefGoogle Scholar
  18. 18.
    Dickinson, D.F. and Sambrooks, J.E.: Intellectual performance in children after circulatory arrest with profound hypothermia in infancy. Arch. Dis. Child., 54: 1–6, 1979.PubMedCrossRefGoogle Scholar
  19. 19.
    Rosenthal, A. and Castaneda, A.R.: Growth and development after cardiovascular surgery in infants and children. Postoperative congenital heart diseases. pp. 119–129, Grune & Stratton, N.Y., 1975.Google Scholar
  20. 20.
    Fisk, G.C., Wright, J.S., Turner, B.B., Baker, W. de C., Hicks, R.G., Lethlean, A.K., Stacey, R.B., Lawrence, J.C., Lawrie, G.M., Kalnins, I. and Rose, M.: Cerebral effects of circulatory arrest at 20°C in the infant pig. Anaesth. Intensive Care, 2: 33–42, 1974.PubMedGoogle Scholar
  21. 21.
    Rittenhouse, E.A., Mohri, H., Reichenbach, D.D. and Merendino, K.A.: Morphological alterations in vital organs after prolonged cardiac arrest at low body temperature. Ann. Thorac. Surg., 13: 564–574, 1972.PubMedCrossRefGoogle Scholar

Copyright information

© The Japan Surgical Society 1981

Authors and Affiliations

  • Hiroshi Shida
    • 1
  • Masami Morimoto
    • 1
  • Koichi Inokawa
    • 1
  • Yutaka Ikeda
    • 1
  • Jiro Tsugane
    • 1
  • Hideki Yuzuriha
    • 1
  1. 1.The Second Department of Surgery, Research Laboratory for Cardiovascular DiseasesShinshu University School of MedicineMatsumotoJapan

Personalised recommendations