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Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Neurodevelopmental outcome following open heart surgery in infancy: 6-year follow-up
Bryn Jones1, Frank Muscara2, Owen Lloyd3
11Department of Cardiology,The Royal Children's Hospital,Melbourne,Australia.
Insights
Children who had infant heart surgery generally develop in the average range. However, a significant number show developmental delays, underscoring the need for ongoing monitoring and early intervention.
Area of Science:
- Pediatric Cardiology
- Developmental Psychology
- Neurology
Background:
- Infants undergoing open heart surgery face risks of neurological injury.
- A previous study showed reduced developmental scores at 12 months in this cohort.
- This cohort's long-term neurodevelopmental outcomes require reassessment.
Purpose of the Study:
- To conduct detailed psychometric testing on children post-infant cardiac surgery.
- To evaluate cognitive, academic, and behavioral functioning at school age.
- To identify children needing early intervention.
Main Methods:
- Psychometric testing included intelligence, memory, and academic achievement scales.
- Parent-completed questionnaires assessed executive functioning and behavior.
- 20 children from the original cohort were reassessed at a mean age of 6.6 years.
Main Results:
- Mean scores for intelligence, memory, academics, and executive function were in the average range.
- 20-35% of children exhibited significant difficulties in cognitive and academic areas.
- 35% of children had clinically significant social, emotional, and behavioral problems.
Conclusions:
- Children post-infant cardiac surgery generally function within average ranges.
- A substantial proportion demonstrates below-average development in multiple domains.
- Long-term follow-up and developmental screening are crucial for identifying at-risk children needing intervention.
Background:
Children undergoing open heart surgery are at risk of neurological injury. A cohort of 35 patients, who had undergone cardiac surgery during infancy, had a significant reduction in Bayley Scale of Infant Development scores at a 12-month assessment. This cohort has now reached an appropriate age to reassess developmental progress.
Methods:
Detailed psychometric testing was conducted on 20 children from the original cohort using the Weschler Preschool and Primary Scale of Intelligence, the Wide Range Assessment of Memory and Learning, and the Wechsler Individual Achievement Test. Parents completed the Connor's Rating Scale, the Behaviour Rating Scale of Executive Functioning, and the Child Behaviour Checklist.
Results:
The mean age of the cohort at assessment was 6.6 (standard deviation 0.4) years. Mean scores on all tests of intelligence, memory, academic achievement, and executive function fell within the average range. Of the children, 20-35% were found to have significant difficulties across these areas. Mean scores in the areas of social, emotional, behavioural, and psychological functioning also fell within the average range. Of the children studied, 35% had clinically significant problems in these areas. There was only a weak association between the 12-month scores and the Full-Scale Intelligence Quotient at 6 years.
Conclusion:
Detailed psychometric testing of these children suggests that they generally function in the average range; however, a significant proportion falls below age expectations in all the areas assessed. This highlights the importance of long-term follow-up with routine developmental screening to allow identification of a subgroup that may benefit from early educational and behavioural intervention.
