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Functional limitations in young children with congenital heart defects after cardiac surgery

C Limperopoulos1, A Majnemer, M I Shevell

  • 1School of Physical and Occupational Therapy, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.

Pediatrics
|December 4, 2001
PubMed

Insights

Infants undergoing open-heart surgery often experience significant functional limitations and daily living skill deficits. These neurodevelopmental sequelae impact socialization and require greater clinical attention.

Area of Science:

  • Pediatric Cardiology
  • Neurodevelopmental Pediatrics
  • Pediatric Surgery

Background:

  • Infant mortality rates after open-heart surgery (OHS) have declined significantly.
  • Concerns are rising regarding neurodevelopmental sequelae in infants post-OHS.
  • Previous studies focused on developmental impairments, neglecting functional outcomes and family burden.

Purpose of the Study:

  • To determine the prevalence of functional limitations in young children with congenital heart defects (CHD) after OHS.
  • To investigate the burden of care associated with these functional limitations.
  • To identify risk factors for functional disabilities post-OHS.

Main Methods:

  • Prospective recruitment of 131 infants with CHD undergoing their first OHS.
  • Preoperative, postoperative, and 12-18 month postoperative functional assessments.
  • Utilized the WeeFIM (Functional Independence Measure) and Vineland Adaptive Behavior Scale.

Main Results:

  • Only 21% of children functioned within the expected age range.
  • 37% had moderate disability, 6% severe disability (WeeFIM).
  • 40% had daily living skill difficulties, over 50% had poor socialization skills (Vineland).

Conclusions:

  • High prevalence of functional limitations and dependence in daily living is underappreciated.
  • Pediatricians and developmental specialists should give these outcomes more attention.
  • Risk factors include perioperative neurodevelopment, microcephaly, circulatory arrest duration, ICU stay, age at surgery, and maternal education.
Abstract

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