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Neuropsychomotor development before and after open-heart surgery in infants
Taís Sica da Rocha1, Ana Guardiola, Jefferson Pedro Piva
1Hospital da Criança Santo Antônio, Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil. darochats@hotmail.com
Insights
Neuropsychomotor follow-up in infants after open-heart surgery shows early improvement. Despite initial delays, neurodevelopmental outcomes improved within six months post-discharge, indicating positive recovery trends.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Pediatric Cardiac Surgery
Background:
- Limited Brazilian research exists on infant neurodevelopmental outcomes following open-heart surgery with cardiopulmonary bypass.
- Infants undergoing open-heart surgery are at risk for neurodevelopmental deficits.
Purpose of the Study:
- To assess the neurodevelopmental outcomes of infants undergoing open-heart surgery with cardiopulmonary bypass in Brazil.
- To evaluate changes in neuropsychomotor development before surgery, post-ICU discharge, and 3-6 months after hospital discharge.
Main Methods:
- A prospective study involving 20 infants undergoing open-heart surgery.
- Neurodevelopmental assessment using neurological examination and the Denver Developmental Screening Test II (Denver II).
- Assessments were conducted pre-surgery, post-ICU discharge, and 3-6 months post-hospital discharge.
Main Results:
- Eleven infants (55%) had septal defects; mean cardiopulmonary bypass time was 67 ± 23.6 minutes.
- Fifteen infants presented with altered neurological exams and neurodevelopmental delay pre-surgery.
- At 6 months post-discharge, 6 infants showed normalization; the Denver II test indicated improvement in all domains except personal-social.
Conclusions:
- Infants undergoing open-heart surgery demonstrated early improvements in neuropsychomotor indexes despite initial delays and risks.
- Neurodevelopmental follow-up is crucial for identifying and managing potential deficits in this high-risk population.
- Findings suggest a positive trajectory for neurodevelopmental recovery in the medium term after surgery.
Abstract:
There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenty infants had neurodevelopmental outcomes (neurological exam and Denver II test) assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%). The mean circulatory bypass time was 67 +/- 23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.
