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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Quality of life 4 years after complex heart surgery in infancy
Gonzalo Garcia Guerra1, Charlene M T Robertson, Gwen Y Alton
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. Gonzalo.Guerra@albertahealthservices.ca
Insights
Children undergoing early congenital heart disease surgery had lower quality of life at age 4. Factors like surgery timing and socioeconomic status impacted these outcomes.
Area of Science:
- Pediatric Cardiology
- Quality of Life Research
- Congenital Heart Disease Outcomes
Background:
- Congenital heart disease (CHD) necessitates early surgical intervention.
- Long-term health-related quality of life (HRQoL) post-infancy cardiac surgery requires further investigation.
Purpose of the Study:
- To assess HRQoL at 4 years of age in infants treated for CHD.
- To identify perioperative factors associated with HRQoL outcomes.
Main Methods:
- Prospective cohort study of infants undergoing cardiac surgery before 6 weeks of age.
- HRQoL assessed at age 4 using the Pediatric Quality of Life Inventory (PedsQL) 4.0.
- Comparison with normative data and exploration of perioperative variable associations.
Main Results:
- 130 survivors of complex heart surgery were evaluated.
- Children with biventricular repair showed lower overall and psychosocial PedsQL scores compared to norms.
- Single ventricle repair patients had lower physical health scores; older surgery age and low cardiac output syndrome correlated with worse HRQoL.
Conclusions:
- Infants undergoing early cardiac surgery for CHD experience diminished HRQoL at age 4.
- Age at surgery, postoperative low cardiac output syndrome, and socioeconomic status are significant predictors of long-term HRQoL.
Objective:
To determine the health-related quality of life at 4 years of age in children who had undergone cardiac surgery for congenital heart disease in early infancy.
Methods:
A prospective cohort study of infants undergoing cardiac surgery at 6 weeks of age or younger from July 2000 to June 2005 at the Stollery Children's Hospital. The quality of life was assessed using the Pediatric Quality of Life Inventory, version 4.0, generic core scales, and compared with normative values for the same age. The association between the perioperative variables and health-related quality of life was explored.
Results:
A total of 242 infants underwent complex heart surgery during the study period. Of the 166 eligible survivors, 130 were included. No significant differences were present between the children with single ventricle versus biventricular repairs, except for lower physical health summary scores in the single ventricle patients (P = .007). Compared with the normative data, the children with biventricular repair had lower total Pediatric Quality of Life Inventory, version 4.0, scores (P = .001) and psychosocial health summary scores (P < .001). The children with single ventricle repair also had lower physical health summary scores (P = .003). Older age at surgery and markers of postoperative low cardiac output syndrome were associated with worse health-related quality of life, and greater socioeconomic status was associated with better quality of life.
Conclusions:
At 4 years of age, health-related quality of life was significantly lower in children who had undergone surgery for congenital heart disease in early infancy. An association was found between age at surgery and postoperative low cardiac output and socioeconomic status and quality of life.
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