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Neuropsychological performance in school-aged children with surgically corrected congenital heart disease
Marijke Miatton1, Daniël De Wolf, Katrien François
1Laboratory for Neuropsychology, Department of Internal Medicine, Ghent University, Ghent, Belgium. marijke.miatton@ugent.be
Insights
Children with congenital heart disease (CHD) show mild motor and language deficits years after surgery. Neurodevelopmental delay risk necessitates long-term follow-up for these children.
Area of Science:
- Pediatric Cardiology
- Developmental Neuroscience
- Pediatric Psychology
Background:
- Surgical advancements in congenital heart disease (CHD) have shifted focus to developmental outcomes.
- Understanding the long-term cognitive profile of children post-CHD surgery is crucial.
Purpose of the Study:
- To delineate the specific cognitive profile of children 6 to 12 years after surgical correction of CHD.
- To identify potential neurodevelopmental delays in school-aged children with a history of CHD.
Main Methods:
- A cohort of 43 children with CHD and 43 healthy controls (mean age ~8 years, 10 months) were assessed.
- Cognitive abilities were evaluated using the Wechsler Intelligence Scale for Children-3rd edition and the NEPSY developmental neuropsychological assessment battery.
Main Results:
- Children with CHD exhibited significantly lower scores in Estimated Full Scale IQ.
- Neuropsychological testing revealed deficits in Sensorimotor Functioning, Language, Attention/Executive Functioning, and Memory in the CHD group.
- Children with CHD demonstrated more impulsive behavior compared to controls.
Conclusions:
- Children surgically treated for CHD present with mild motor deficits and subtle language impairments 6-12 years post-operation.
- Attention, executive functioning, and memory are also affected to a lesser extent.
- Long-term neurodevelopmental monitoring is essential for surgically corrected CHD patients due to the risk of school-age delays.
Objective:
As surgical management of children with congenital heart disease (CHD) advanced, developmental outcome became the main focus of contemporary research. In this study, we specify the cognitive profile of children with CHD, 6 to 12 years postoperatively.
Study Design:
Patients with CHD (n = 43, mean age 8 years, 8 months) and healthy controls (n = 43, mean age 8 years, 11 months), were examined with an abbreviated intelligence scale (Wechsler Intelligence Scale for Children-3rd edition, Dutch version) and a developmental neuropsychological assessment battery (NEPSY [a developmental NEuroPSYchological assessment]).
Results:
We identified significantly lower scores for the CHD group on Estimated Full Scale IQ (P < .01). Neuropsychological assessment revealed lower scores for the CHD group on the cognitive domains of Sensorimotor Functioning (P < .001), Language (P < .001), Attention and Executive Functioning (P < .05), and Memory (P < .05). Children with CHD displayed more impulsive test behavior than healthy peers. No differences on IQ or cognitive domains were found between the cyanotic and the acyanotic CHD group.
Conclusions:
Six to 12 years postoperatively, children with CHD display a neuropsychological profile with mainly mild motor deficits and subtle difficulties with language tasks. Attention/executive functioning and memory also appear involved but to a lesser degree. Long-term follow-up of children with surgically corrected CHD, even when hemodynamically successful, is warranted, as they are at risk for neurodevelopmental delay at school age.
