Abstract

Methods: Between February 2018 and March 2022, a total of 60 patients (49 male, 11 female; mean age, 23.5±8.8 days; range, 2 to 106 days) who were operated with a diagnosis of simple transposition of the great arteries and discharged uneventfully were included. Preoperative balloon atrial septostomy was performed in 33 patients (BAS+ group), while 27 patients (BAS? group) did not undergo the procedure. Finally, 13 patients from the septostomy group and 12 patients from the non-septostomy group were available for follow-up. Neurodevelopment in infants was assessed using the 3rd edition of the Bayley Scales of Infant and Toddler Development (Bayley-III) scoring.

Results: The mean cognitive, language, and motor composite scores were 85.00±11.73, 89.62±12.29, and 83.38±14.83 in the BAS+ group and 94.58±18.40, 99.83±15.71, and 90.00±18.73 in the BAS- group, respectively (p=0.131, p=0.123, and p=0.689, respectively). Ballon atrial septostomy was the only factor that caused a decrease in all composite scores according to Bayley-III scoring, although not statistically significant. There was a significant negative correlation between C-reactive protein and all composite scores. There was also a significant negative correlation between cardiopulmonary bypass time, cross-clamping time, mean plasma lactate levels (mmol/L) on postoperative Days 2-5, postoperative creatinine, and motor composite scores. There was a significant positive correlation between growth weight and head circumference and all three CSs.

Conclusion: Ballon atrial septostomy may adversely affect the neurodevelopmental process in neonates. We believe that close monitoring of postoperative blood values such as lactate, C-reactive protein and creatinine, and avoiding hypoxemia and keeping them at optimal levels are crucial. Good weight gain can also contribute to the neurodevelopment of patients.