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Updated: Apr 23, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Neurodevelopment and behavior after transcatheter versus surgical closure of secundum type atrial septal defect
Iemke Sarrechia1, Daniël De Wolf2, Marijke Miatton3
1Department of Experimental Psychology, Ghent University, Ghent, Belgium.
Insights
Children treated for atrial septal defect (ASD-II) show neurodevelopmental challenges in attention, executive functioning, and social cognition. These findings highlight the need for ongoing neurodevelopmental and behavioral monitoring in affected children.
Area of Science:
- Pediatric Cardiology
- Neuropsychology
- Developmental Pediatrics
Background:
- Atrial septal defect, secundum type (ASD-II) is a common congenital heart condition.
- Treatment options include open-heart surgery and transcatheter repair.
- Long-term neurodevelopmental outcomes after ASD-II treatment require further investigation.
Purpose of the Study:
- To evaluate the neuropsychological and behavioral profiles of school-aged children post-treatment for ASD-II.
- To compare outcomes between open-heart surgery and transcatheter repair groups.
- To identify factors associated with neurodevelopmental outcomes.
Main Methods:
- A cohort of 48 children treated for ASD-II was assessed using the Wechsler Intelligence Scale for Children and the Developmental Neuropsychological Assessment.
- A matched group of healthy children served as controls.
- Parental reports on behavior and academic performance were collected using the Achenbach Child Behavior Checklist.
Main Results:
- Children treated for ASD-II exhibited significantly lower scores in attention, executive functioning, language, working memory, sensorimotor skills, social cognition, and visuospatial processing compared to controls.
- Minor differences were observed in visuospatial processing between surgical and transcatheter repair groups.
- Factors such as socioeconomic status, hospital stay duration, and defect size correlated with neurocognitive outcomes. Parents reported increased behavioral and academic issues.
Conclusions:
- Children treated for ASD-II present with diverse neuropsychological difficulties, potentially leading to learning and academic underachievement.
- No significant differences in neurodevelopmental outcomes were found based on treatment modality (surgery vs. catheterization).
- Routine neurodevelopmental and behavioral follow-up is recommended for school-aged children after ASD-II treatment.
Objective:
To assess the neuropsychological and behavioral profiles of school-aged children treated for atrial septal defect, secundum type (ASD-II) with open-heart surgery or catheterization.
Study Design:
Patients (n = 48; mean age, 9 years, 3 months) and a matched healthy group (mean age, 9 years, 2 months) were evaluated with a shortened intelligence scale (Wechsler Intelligence Scale for Children, third edition, Dutch version) and a developmental neuropsychological test battery (Developmental Neuropsychological Assessment, second edition, Dutch version). Parents completed behavioral checklists (Achenbach Child Behavior Checklist for Children aged 6-18). Hospitalization variables were retrieved from medical files for studying associations with long-term neurodevelopment.
Results:
Compared with the healthy matched controls, patients treated for ASD-II had significantly lower scores on subtasks underlying such Developmental Neuropsychological Assessment, second edition, Dutch version domains as Attention and Executive Functioning, Language, Working Memory, Sensorimotor Functioning, Social Cognition, and Visuospatial Information Processing. Only subtle differences, mainly in Visuospatial Information Processing, were found between the surgical repair and transcatheter repair groups. Socioeconomic status, longer hospital stay, and larger defect size were associated with neurocognitive outcome measures. Parents of patients reported more thought problems, posttraumatic stress problems, and lower school performance compared with parents of healthy peers.
Conclusion:
After treatment for ASD-II, children display a range of neuropsychologic difficulties that may increase their risk for learning problems and academic underachievement. Differences related to treatment were not found. Our results suggest that neurodevelopmental and behavioral follow-up at school age is warranted in this group.
