Adolescents with tetralogy of Fallot: neuropsychological assessment and structural brain imaging

Cardiol Young. 2015 Feb;25(2):338-47. doi: 10.1017/S1047951114000031. Epub 2014 Feb 11.


Background: Few data are available on the neuropsychological, behavioural, or structural brain imaging outcomes in adolescents who underwent corrective surgery in infancy for tetralogy of Fallot.

Methods: In this single-centre cross-sectional study, we enrolled 91 adolescents (13-16 years old) with tetralogy of Fallot and 87 referent subjects. Assessments included tests of academic achievement, memory, executive functions, visual-spatial skills, attention, and social cognition, as well as brain magnetic resonance imaging.

Results: Genetic abnormalities or syndromes were present in 25% of tetralogy of Fallot patients, who had markedly greater neuropsychological morbidities than did patients without a syndrome. However, even patients without a syndrome performed significantly worse than the referent group or population norms in all of the neuropsychological domains assessed. In multivariable regression in those without a genetic/phenotypic syndrome, the strongest predictors of adverse late neurodevelopmental outcomes included a greater number of complications at the first operation, more total surgical complications across all operations, and occurrence of post-operative seizures. The presence of at least one abnormality on structural magnetic resonance imaging was more frequent in tetralogy of Fallot patients than the referent group (42% versus 8%).

Conclusions: Adolescents with tetralogy of Fallot are at increased neurodevelopmental risk and would benefit from ongoing surveillance and educational supports even after childhood.

Keywords: magnetic resonance imaging.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Achievement
  • Adolescent
  • Attention
  • Brain / pathology*
  • Cognition Disorders / complications
  • Cognition Disorders / psychology*
  • Executive Function
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Memory
  • Neuropsychological Tests
  • Regression Analysis
  • Social Perception
  • Social Skills
  • Space Perception
  • Survivors / psychology*
  • Tetralogy of Fallot / complications
  • Tetralogy of Fallot / psychology*
  • Tetralogy of Fallot / surgery