Predictors of developmental disabilities after open heart surgery in young children with congenital heart defects
Abstract
Objectives To determine the prevalence of persistent developmental impairments in children with congenital heart defects and to identify factors that enhance risk for an adverse outcome.Study design Eligible infants (n = 131) <2 years of age requiring open heart surgery were recruited prospectively. Subjects were assessed during surgery and again 12 to 18 months later with standardized developmental assessments and formal neurologic examinations.Results Mean age at follow-up testing was 19.1 +/- 6.6 months. Assessments indicated that 41% had abnormal neurologic examinations. Gross and/or fine motor delays were documented in 42%, and 23% demonstrated global developmental delay. Univariate and multiple regression models identified the following factors increasing the risk for persistent developmental deficits: preoperative and acute postoperative neurodevelopmental status and microcephaly, type of heart lesion, length of deep hypothermic circulatory arrest, age at surgery, and days in the intensive care unit (P <.05).Conclusions Children with congenital heart defects commonly have ongoing neurologic, motor, and developmental deficits well after surgical correction. The cause is multifactorial and includes brain injury before, during, and after heart surgery.
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A high prevalence of anatomic and functional neurologic abnormalities has been documented before surgery in newborns with congenital heart disease, and such abnormalities are associated with childhood developmental status.
“Reports from a number of investigators have documented a high prevalence of anatomic and functional neurologic abnormalities prior to surgery in newborns with CHD [9-17], and an association of such abnormalities with childhood developmental status [11,13,18,19].”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [18]
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- Authors
- Limperopoulos, C., Majnemer, A., Shevell, M. I., Rohlicek, C., Rosenblatt, B., Tchervenkov, C., & Darwish, H. Z.
- Affiliations
- Montreal Children's Hospital (CA)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 141
- Issue
- 1
- Pages
- 51-58
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W2076381041
- Cited by
- 323
- References
- 47
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 11 · 2023: 12 · 2022: 13 · 2021: 12 · 2020: 18 · 2019: 19 · 2018: 12 · 2017: 17 · 2016: 10 · 2015: 11 · 2014: 17 · 2013: 10 · 2012: 23
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- congenital heart disease, open heart surgery, developmental disabilities, neurodevelopmental outcomes, motor delay, global developmental delay, microcephaly, deep hypothermic circulatory arrest, ICU length of stay, brain injury, risk factors, infants
- MeSH terms
- Abnormalities, Multiple, Cardiopulmonary Bypass, Developmental Disabilities, Heart Defects, Congenital, Humans, Infant, Infant, Newborn, Microcephaly, Postoperative Complications, Prospective Studies, Quebec, Risk, Prevalence, Multivariate Analysis, Linear Models, Motor Skills Disorders
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