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Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Functional, quality of life, and neurodevelopmental outcomes after congenital cardiac surgery
Megan L Ringle1, Gil Wernovsky2
1Pediatric Residency, Nicklaus Children׳s Hospital, Miami Children׳s Health System, Miami, FL.
Insights
Advances in heart disease treatment allow more children to survive, but many face developmental and health challenges. Early interventions and comprehensive care help these children thrive with fulfilling lives.
Area of Science:
- Pediatric Cardiology
- Developmental Pediatrics
- Congenital Heart Disease
Background:
- Medical advancements have increased survival rates for children with complex congenital heart diseases.
- Despite improved survival, significant neurodevelopmental sequelae and comorbidities persist in these children.
Purpose of the Study:
- To review the challenges and outcomes for school-aged children surviving complex congenital heart diseases.
- To highlight the impact of neurodevelopmental issues and comorbidities on quality of life.
- To emphasize the benefits of innovative perioperative techniques and psychosocial interventions.
Main Methods:
- Review of current literature on outcomes for pediatric survivors of complex congenital heart disease.
- Analysis of neurodevelopmental, functional, and psychosocial challenges.
- Evaluation of interventions and care models.
Main Results:
- Survivors exhibit higher frequencies of developmental delays, learning disabilities, and speech challenges.
- Adolescents face issues with processing speed, executive function, exercise intolerance, obesity, and mental health.
- Innovative perioperative care and early psychosocial support facilitate positive long-term outcomes.
Conclusions:
- Most children with complex congenital heart disease can achieve normal intelligence and social skills with appropriate support.
- Comprehensive medical home models are crucial for optimizing quality of life for survivors and their families.
- Multidisciplinary care addressing medical, developmental, and psychosocial needs is essential for long-term well-being.
Abstract:
Throughout the past few decades, advances in cardiology, neonatal intensive care, and surgical techniques have resulted in a growing cohort of thriving school-aged children with previously lethal complex congenital heart diseases. While survival has increased, there remains significant morbidity following repair including neurodevelopmental sequelae. Compared to children with a structurally normal heart, these infants and children have a higher frequency of abnormalities in tone, feeding, and delayed developmental milestones, as well as challenges with speech and learning disabilities, while a higher proportion of adolescents suffer from problems with processing speed, executive function, and a unique set of medical hardships related to exercise intolerance and obesity, medication burden, and mental health comorbidities. Innovative perioperative techniques and early psychosocial intervention in these young survivors has shown that despite the obstacles, the majority of these children can grow to have fulfilling lives with intelligence and social skills in the normal range. Additionally, a comprehensive medical home aids in optimizing the quality of life for these children and their families.
