Evidence map›Paper›PMID 31132861›Full record

Observational studyCirculation2019

Associations Between Age at Arterial Switch Operation, Brain Growth, and Development in Infants With Transposition of the Great Arteries.

Jessie Mei Lim, Prashob Porayette, Davide Marini, Vann Chau, Stephanie H Au-Young, Amandeep Saini, Linh G Ly, Susan Blaser, Manohar Shroff, Helen M Branson and 6 more

Registry-linked trialOpen access · bronzeAbstract readComparative StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05160116 (Influence of Timing of Switch Operation in Transposition of Great Arteries), which is not on this map. Cited by 38 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 1 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05160116 completednot on this mapstarted 2021, after this paper: background citation

Influence of Timing of Switch Operation in Transposition of Great Arteries

TypeobservationalSponsorBrugmann University HospitalRan2021 to 2022Enrolled151ConditionsTransposition of Great Vessels
3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 2 countries.

Jessie Mei LimDepartment of Physiology (J.M.L.), University of Toronto, Canada.
Prashob PorayetteDivision of Cardiology (P.O., D.M., A.S., M. Seed), The Hospital for Sick Children, Toronto, Canada.
Davide MariniDivision of Cardiology (P.O., D.M., A.S., M. Seed), The Hospital for Sick Children, Toronto, Canada.
Vann ChauDivision of Neurology (V.C., S.H.A.-Y., S.P.M.), The Hospital for Sick Children, Toronto, Canada.
Stephanie H Au-YoungDivision of Neurology (V.C., S.H.A.-Y., S.P.M.), The Hospital for Sick Children, Toronto, Canada.
Amandeep SainiDivision of Cardiology (P.O., D.M., A.S., M. Seed), The Hospital for Sick Children, Toronto, Canada.
Linh G LyDivision of Neonatology (V.C., L.G.L.), The Hospital for Sick Children, Toronto, Canada.
Susan BlaserDepartment of Diagnostic Imaging (S.B., M. Shroff, H.M.B.), The Hospital for Sick Children, Toronto, Canada.
Manohar ShroffDepartment of Medical Imaging (M. Shroff), University of Toronto, Canada.
Helen M BransonDepartment of Diagnostic Imaging (S.B., M. Shroff, H.M.B.), The Hospital for Sick Children, Toronto, Canada.
Renee SananesDepartment of Pediatrics (R.S., S.P.M., M. Seed), University of Toronto, Canada.
Edward J HickeyDivision of Cardiovascular Surgery (E.J.H., G.V.A.), The Hospital for Sick Children, Toronto, Canada.
J William GaynorDepartment of Surgery, Children's Hospital of Philadelphia, PA (J.W.G.).
Glen Van ArsdellDivision of Cardiovascular Surgery (E.J.H., G.V.A.), The Hospital for Sick Children, Toronto, Canada.
Steven P MillerDepartment of Pediatrics (R.S., S.P.M., M. Seed), University of Toronto, Canada.
Mike SeedDepartment of Pediatrics (R.S., S.P.M., M. Seed), University of Toronto, Canada.
Hospital for Sick Children · CAUniversity of Toronto · CAChildren's Hospital of Philadelphia · US

Funding

CIHR MOP 142204
6 · The paper itself

Abstract

backgroundBrain injury, impaired brain growth, and long-term neurodevelopmental problems are common in children with transposition of the great arteries. We sought to identify clinical risk factors for brain injury and poor brain growth in infants with transposition of the great arteries undergoing the arterial switch operation, and to examine their relationship with neurodevelopmental outcome.

methodsThe brains of 45 infants with transposition of the great arteries undergoing surgical repair were imaged pre- and postoperatively using magnetic resonance imaging. Brain weight z scores were calculated based on brain volume and autopsy reference data. Brain injury scores were determined as previously described. Neurodevelopment was assessed at 18 months using the Bayley-III scores of infant development. The relationships between clinical variables, brain injury, perioperative brain growth, and 18-month Bayley-III scores were analyzed.

resultsOn preoperative imaging, moderate or severe white matter injury was present in 10 of 45 patients, whereas stroke was seen in 4 of 45. A similar prevalence of injury was seen on postoperative imaging, and we were unable to identify any clinical risk factors for brain injury. Brain weight z scores decreased perioperatively in 35 of 45 patients. The presence of a ventricular septal defect ( P=0.009) and older age at surgery ( P=0.007) were associated with impaired perioperative brain growth. When patients were divided into those undergoing surgery during the first 2 weeks of life (32/45) versus those being repaired later (13/45), infants repaired later had significantly worse perioperative brain growth (late repair postoperative brain weight z = -1.0±0.90 versus early repair z = -0.33±0.64; P=0.008). Bayley-III testing scores fell within the normal range for all patients, although age at repair ( P=0.03) and days of open chest ( P=0.03) were associated with a lower composite language score, and length of stay was associated with a lower composite cognitive score ( P=0.02).

conclusionsSurgery beyond 2 weeks of age is associated with impaired brain growth and slower language development in infants with transposition of the great arteries cared for at our center. Although the mechanisms underlying this association are still unclear, extended periods of cyanosis and pulmonary overcirculation may adversely impact brain growth and subsequent neurodevelopment.

Indexed as

Arterial Switch OperationChild DevelopmentAge FactorsAutopsyBrainBrain DiseasesChild LanguageDiffusion Magnetic Resonance ImagingHumansInfantInfant BehaviorInfant, NewbornOntarioOrgan SizeProspective StudiesTime Factorsarterial switch operationbraingrowth & developmentsurgerytransposition of great vessels

Identifiers

PMID31132861
OpenAlexW2947540670

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.