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Cognitive function in congenital heart disease after cardiac surgery with extracorporeal circulation
Xiang-Cui Fan1, Mao Ye, Da-Zhen Li
1Division of Anesthesiology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Insights
Children under 4 with serious congenital heart disease (CHD) show improved cognitive function after cardiac surgery with extracorporeal circulation (ECC). Younger children and those with cyanotic heart disease experience more significant, though temporary, cognitive changes.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Pediatric Cardiac Surgery
Background:
- Congenital heart disease (CHD) can negatively impact children's cognitive development.
- Evaluating cognitive and academic functioning post-cardiac surgery is crucial for pediatric patients.
Purpose of the Study:
- To assess cognitive and academic changes in children under 4 with serious CHD after cardiac surgery using extracorporeal circulation (ECC).
Main Methods:
- 100 children (aged 0-4 years) with cyanotic (35) and acyanotic (65) CHD underwent neuropsychological evaluation using the Gesell Developmental Schedule (GDS).
- Evaluations were conducted pre-operation and at 1 week, 1, 3, and 6 months post-operation.
Main Results:
- Gesell Developmental Schedule (GDS) scores were lower post-surgery but improved over time (P<0.01).
- Extracorporeal circulation (ECC) impacted GDS scores, with cyanotic children showing more significant effects.
- Younger children and cyanotic children experienced more pronounced, albeit temporary, cognitive deficits post-surgery.
Conclusions:
- Younger children exhibit greater GDS score increases after cardiac surgery with ECC.
- ECC primarily affects cognitive and academic performance in cyanotic children within the first month post-operation.
Background:
Congenital heart disease (CHD) may cause deleterious effects on cognitive function in children. This study aimed to evaluate the changes of the cognitive and academic functioning in children aged less than 4 years with serious CHD following cardiac surgery with extracorporeal circulation (ECC).
Methods:
A total of 100 children, aged 0-4 years with cyanotic (35) and acyanotic (65) heart diseases who had undergone cardiac surgery with ECC, were subjected to neuropsychological and behavioral evaluation using the Gesell Developmental Schedule (GDS) before operation and at 1 week, and 1, 3 and 6 months after operation.
Results:
The GDS scores in the first postoperative week were significantly lower than those before operation, but the scores increased gradually (P<0.01). ECC affected the GDS scores after operation, with the cyanotic children being more significantly affected than the acyanotic children. The GDS scores were negatively correlated with the age at each time point. The GDS scores were significantly lower in the cyanotic children than in the acyanotic children at 1 and 3 months postoperatively (P<0.01), but there was no significant difference at 6 months (P<0.05).
Conclusions:
After cardiac surgery with ECC, the younger the children who have cardiac surgery, the more significantly the GDS score increases. The ECC mainly affects the cognitive ability and academic performance in cyanotic children in one month postoperatively.
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