Open Access
CASE REPORT
Stubborn Hypoxia in Neonates with D-Transposition of the Great Arteries after Arterial Switch Operation: Central Sleep Apnea as the Cause and Potential Indicator of Brain Immaturity
Camden L. Hebson1,*, Kyle Bliton2, Amr Y. Hammouda1, Kaitlyn Barr3, W. Hampton Gray4, Mohini Gunnett2, Waldemar F. Carlo1
1 Department of Pediatrics, Division of Pediatric Cardiology, University of Alabama Birmingham, Birmingham, 35233, USA
2 Department of Pediatrics, Division of Pediatric Pulmonology, University of Alabama Birmingham, Birmingham, 35233, USA
3 Department of Pediatrics, University of Alabama Birmingham, Birmingham, 35233, USA
4 Department of Surgery, Division of Cardiothoracic Surgery, University of Alabama Birmingham, Birmingham, 35233, USA
* Corresponding Author: Camden L. Hebson. Email:
Congenital Heart Disease 2024, 19(2), 185-195. https://doi.org/10.32604/chd.2024.048871
Received 20 December 2023; Accepted 21 February 2024; Issue published 16 May 2024
Abstract
D-transposition of the great arteries (d-TGA) is surgically repaired with the arterial switch operation (ASO) with excellent results, however short and long-term morbidities still develop including neurocognitive delay. Clinically significant central sleep apnea is uncommon in non-premature infants, but when present indicates immature autonomic control of respiration likely due to a neurologic disorder. We report the unanticipated finding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO, with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal development. Within this report, we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea, neurodevelopmental outcomes after ASO, and the important overlap of these entities in the care of patients going forward.
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APA Style
Hebson, C.L., Bliton, K., Hammouda, A.Y., Barr, K., Gray, W.H. et al. (2024). Stubborn hypoxia in neonates with d-transposition of the great arteries after arterial switch operation: central sleep apnea as the cause and potential indicator of brain immaturity. Congenital Heart Disease, 19(2), 185-195. https://doi.org/10.32604/chd.2024.048871
Vancouver Style
Hebson CL, Bliton K, Hammouda AY, Barr K, Gray WH, Gunnett M, et al. Stubborn hypoxia in neonates with d-transposition of the great arteries after arterial switch operation: central sleep apnea as the cause and potential indicator of brain immaturity. Congeni Heart Dis. 2024;19(2):185-195 https://doi.org/10.32604/chd.2024.048871
IEEE Style
C.L. Hebson et al., "Stubborn Hypoxia in Neonates with D-Transposition of the Great Arteries after Arterial Switch Operation: Central Sleep Apnea as the Cause and Potential Indicator of Brain Immaturity," Congeni. Heart Dis., vol. 19, no. 2, pp. 185-195. 2024. https://doi.org/10.32604/chd.2024.048871