Neurocognitive Development After Pediatric Heart Surgery

Pediatrics. 2016 Jun;137(6):e20154675. doi: 10.1542/peds.2015-4675.

Abstract

Objectives: Children with congenital heart disease (CHD) often have neurocognitive deficits, sometimes with a detrimental impact on daily and school functioning. These deficits may increase through childhood. In this study, we investigated whether children with CHD, who underwent heart surgery as infants, show more neurocognitive deficits, especially in the executive functions, as they get older, compared with healthy controls.

Methods: In this longitudinal follow-up study, 107 children with CHD and 77 healthy control children underwent extensive neurocognitive testing at 4 years of age. Ninety-three percent of the children (100 patients with CHDs and 72 controls) underwent a second neurocognitive testing 3 years later. Intelligence, visual-motor integration (VMI), alertness, motor coordination, executive functions, and psychosocial functioning were assessed.

Results: IQ scores were consistently lower in the CHD group (P < .001); however, the difference of 11.7 IQ points between both groups at follow-up 1 decreased to 7 IQ points at follow-up 2 (P = .003). Inhibition reaction time had improved in both study groups at follow-up 2 (P < .001) and did not differ between both groups from follow-up 1 to follow-up 2 (P = .849). Deficits in VMI, alertness, motor coordination, and psychosocial functioning also did not worsen for patients with CHDs at follow-up 2, compared with healthy controls.

Conclusions: Children with CHD, who underwent heart surgery as infants, do not show an increase of neurocognitive deficits between the ages of 4 and 7 years, compared with healthy controls. Patients with CHDs keep deficits in intelligence, VMI, and psychosocial functioning, but seem to partially grow out of their deficits.

Trial registration: ClinicalTrials.gov NCT01632813.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Surgical Procedures / adverse effects*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cognition Disorders / etiology*
  • Developmental Disabilities / etiology*
  • Executive Function
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / psychology*
  • Heart Defects, Congenital / surgery
  • Humans
  • Male
  • Neuropsychological Tests
  • Postoperative Complications

Associated data

  • ClinicalTrials.gov/NCT01632813