Abstract
BACKGROUND: The aim of this study was to investigate the effect of preoperative balloon atrial septostomy and intraoperative parameters on neurodevelopmental outcomes in neonates operated for transposition of the great arteries. 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 3(rd) 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.