OBJECTIVE: To determine the risk factors for adverse neurodevelopmental outcomes in school-age children after full flow open-heart surgery for congenital heart disease. METHODS: The outcome was assessed in 117 children without a genetic comorbidity at a mean age of 10.4 ± 2.5 years. Intelligence was assessed using the Raven's Progressive Matrices and neuromotor function using the Zurich Neuromotor Assessment. Risk factors were retrieved from detailed chart review. RESULTS: The mean intelligence score was 89 ± 16, significantly lower than the norm (P < .001). Cerebral palsy was diagnosed in 10% of patients. Poor neuromotor performance (less than p10) was present in 15% to 20% of the children, depending on the motor task (all P < .001). Pure motor and static balance performance was also significantly impaired when patients with cerebral palsy were excluded (P < .01). Intelligence was only related to socioeconomic status (P = .006), and neuromotor outcome was related to the length of hospital stay and postoperative neurologic abnormalities (P < .03). The extracorporeal circulation time was related to adaptive fine motor performance (P = .05). All other variables were not related to outcome. CONCLUSIONS: Children without a genetic comorbidity are at risk of long-term intellectual and motor impairments also after full-flow cardiac repair. Surgery-related parameters play a less important role for adverse outcomes than postoperative complications. Our findings stress the importance of specialized follow-up assessments for all children with CHD undergoing open heart surgery.
OBJECTIVE: To determine the risk factors for adverse neurodevelopmental outcomes in school-age children after full flow open-heart surgery for congenital heart disease. METHODS: The outcome was assessed in 117 children without a genetic comorbidity at a mean age of 10.4 ± 2.5 years. Intelligence was assessed using the Raven's Progressive Matrices and neuromotor function using the Zurich Neuromotor Assessment. Risk factors were retrieved from detailed chart review. RESULTS: The mean intelligence score was 89 ± 16, significantly lower than the norm (P < .001). Cerebral palsy was diagnosed in 10% of patients. Poor neuromotor performance (less than p10) was present in 15% to 20% of the children, depending on the motor task (all P < .001). Pure motor and static balance performance was also significantly impaired when patients with cerebral palsy were excluded (P < .01). Intelligence was only related to socioeconomic status (P = .006), and neuromotor outcome was related to the length of hospital stay and postoperative neurologic abnormalities (P < .03). The extracorporeal circulation time was related to adaptive fine motor performance (P = .05). All other variables were not related to outcome. CONCLUSIONS:Children without a genetic comorbidity are at risk of long-term intellectual and motor impairments also after full-flow cardiac repair. Surgery-related parameters play a less important role for adverse outcomes than postoperative complications. Our findings stress the importance of specialized follow-up assessments for all children with CHD undergoing open heart surgery.
Authors: Caren S Goldberg; Minmin Lu; Lynn A Sleeper; William T Mahle; J William Gaynor; Ismee A Williams; Kathleen A Mussatto; Richard G Ohye; Eric M Graham; Deborah U Frank; Jeffrey P Jacobs; Catherine Krawczeski; Linda Lambert; Alan Lewis; Victoria L Pemberton; Renee Sananes; Erica Sood; Stephanie B Wechsler; David C Bellinger; Jane W Newburger Journal: J Pediatr Date: 2014-06-19 Impact factor: 4.406
Authors: M Makki; I Scheer; C Hagmann; R Liamlahi; W Knirsch; H Dave; V Bernet; K Batinic; B Latal Journal: AJNR Am J Neuroradiol Date: 2012-10-04 Impact factor: 3.825
Authors: Maaike C A Sprong; Marco van Brussel; Linda S de Vries; Janjaap van der Net; Joppe Nijman; Johannes M P J Breur; Martijn G Slieker Journal: Children (Basel) Date: 2022-04-16