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Updated: Jul 15, 2026
Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children
Published on: April 29, 2013
Neurodevelopmental outcome after congenital heart surgery: results from an institutional registry
Joseph M Forbess1, Karen J Visconti, Camille Hancock-Friesen
1Department of Cardiovascular Surgery, Children's Hospital, Boston, Mass 02115, USA. forbess@cardio.tch.harvard.edu
Insights
Children with critical congenital heart disease (CHD) generally have normal intellectual abilities. However, lower socioeconomic status (SES) and velocardiofacial syndrome (VCFS) are linked to lower IQ scores in these children.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Congenital Heart Disease
Background:
- Improved survival rates in critical congenital heart disease (CHD) necessitate understanding long-term neurodevelopmental outcomes.
- This study investigates neurodevelopmental sequelae in 5-year-old children post-CHD repair or palliation.
Purpose of the Study:
- To assess the neurodevelopmental status of children with critical CHD.
- To identify factors impacting neurodevelopment in this population.
Main Methods:
- A neuropsychological test battery was administered to 243 children.
- Data collected included anatomic, demographic, and perioperative factors.
- Multiple regression analysis was used to identify predictors of neurodevelopmental outcomes.
Main Results:
- Overall, children with CHD demonstrated average intellectual functioning (mean FSIQ=96.8).
- Lower socioeconomic status (SES) and velocardiofacial syndrome (VCFS) significantly predicted lower full-scale IQ (FSIQ).
- Single ventricle diagnosis, longer ICU stay, and extended hypothermic circulatory arrest (HCA) showed trends toward lower FSIQ.
Conclusions:
- Children with CHD typically exhibit average intellectual abilities.
- Lower SES and VCFS are associated with diminished IQ scores.
- Specific surgical factors and diagnoses may influence neurodevelopmental outcomes.
Objective:
Increased survival in children with critical congenital heart disease (CHD) has raised interest in the neurodevelopmental sequelae of these lesions. This investigation is part of an institutional effort to examine the neurodevelopment of 5-year-old children following repair or palliation of CHD.
Methods:
We performed a battery of neuropsychological tests on a sample of 243 children between 1998 and 2001.
Results:
In the sample as a whole, mean full-scale (FSIQ), verbal (VIQ), and performance (PIQ) IQ scores were in the normal range (96.8+/-15.9, 97.8+/-14.6, and 96.3+/-17.1, respectively). Anatomic, demographic, and perioperative factors were assessed for impact on neurodevelopment. In multiple regression analysis, lower socioeconomic status (SES) and the diagnosis of velocardiofacial syndrome (VCFS) predicted a lower FSIQ (P=0.01, and P=0.001, respectively). A single ventricle diagnosis (P=0.06), longer postoperative ICU stay (P=0.08), and cumulative duration of hypothermic circulatory arrest (HCA) (P=0.09) approached significance as predictors of lower FSIQ.
Conclusion:
Children with CHD, on the whole, appear to be performing within the average range in terms of intellectual abilities. Lower SES and VCFS are associated with lower IQ scores. Trends toward worse outcomes were observed in single ventricle patients, biventricular patients with longer postrepair ICU stays, and patients subjected to longer periods of HCA.
