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Neurodevelopmental outcome following open heart surgery in infancy: 6-year follow-up

Published online by Cambridge University Press:  10 July 2014

Bryn Jones ,
Frank Muscara ,
Owen Lloyd ,
Lynne McKinlay  and
Robert Justo
Bryn Jones*
Affiliation:
Department of Cardiology, The Royal Children’s Hospital, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Australia
Frank Muscara
Affiliation:
Murdoch Children’s Research Institute, Melbourne, Australia
Owen Lloyd
Affiliation:
Queensland Paediatric Rehabilitation Service, Royal Children’s Hospital, Brisbane, Australia
Lynne McKinlay
Affiliation:
Queensland Paediatric Rehabilitation Service, Royal Children’s Hospital, Brisbane, Australia
Robert Justo
Affiliation:
Queensland Paediatric Cardiac Service, Mater Health Services, Brisbane, Australia
*
Correspondence to: Dr B. Jones, Department of Cardiology, The Royal Children’s Hospital, Flemington Road, Parkville, Melbourne, Victoria 3052, Australia. Tel:+61 3 93455713; Fax:+61 3 93456001. E-mail: bryn.jones@rch.org.au
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Abstract

Background: Children undergoing open heart surgery are at risk of neurological injury. A cohort of 35 patients, who had undergone cardiac surgery during infancy, had a significant reduction in Bayley Scale of Infant Development scores at a 12-month assessment. This cohort has now reached an appropriate age to reassess developmental progress. Methods: Detailed psychometric testing was conducted on 20 children from the original cohort using the Weschler Preschool and Primary Scale of Intelligence, the Wide Range Assessment of Memory and Learning, and the Wechsler Individual Achievement Test. Parents completed the Connor’s Rating Scale, the Behaviour Rating Scale of Executive Functioning, and the Child Behaviour Checklist. Results: The mean age of the cohort at assessment was 6.6 (standard deviation 0.4) years. Mean scores on all tests of intelligence, memory, academic achievement, and executive function fell within the average range. Of the children, 20–35% were found to have significant difficulties across these areas. Mean scores in the areas of social, emotional, behavioural, and psychological functioning also fell within the average range. Of the children studied, 35% had clinically significant problems in these areas. There was only a weak association between the 12-month scores and the Full-Scale Intelligence Quotient at 6 years. Conclusion: Detailed psychometric testing of these children suggests that they generally function in the average range; however, a significant proportion falls below age expectations in all the areas assessed. This highlights the importance of long-term follow-up with routine developmental screening to allow identification of a subgroup that may benefit from early educational and behavioural intervention.

Keywords

Heart defectscongenitalpaediatric cardiac surgerydevelopmental outcome
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 5 , June 2015 , pp. 903 - 910
Copyright
© Cambridge University Press 2014 

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