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Incidence and predictive factors for development of ADHD post congenital heart disease surgery-a single tertiary

Akriti Gera1, Amit Misri1, Pankaj Bajpai1

  • 1Department of Pediatric Cardiology and Congenital Heart Disease, Medanta Hospital, Gurugram, Haryana, India.

Frontiers in Cardiovascular Medicine
|May 11, 2026
PubMed

Insights

Attention-deficit hyperactivity disorder (ADHD) affects 32.6% of children one year after pediatric cardiac surgery. Longer surgery times and hospital stays are significant risk factors for developing ADHD post-surgery.

Area of Science:

  • Pediatric Cardiology
  • Neurodevelopmental Disorders
  • Surgical Outcomes

Background:

  • Congenital heart disease (CHD) survival rates are increasing, leading to more adults with the condition.
  • Attention-deficit hyperactivity disorder (ADHD) is common in children with CHD due to disease and surgical factors.
  • ADHD is often underdiagnosed in this population.

Purpose of the Study:

  • To determine the incidence of ADHD one year after pediatric cardiac surgery.
  • To identify clinical and operative risk factors associated with ADHD development post-surgery.

Main Methods:

  • 98 children aged 3-18 years undergoing cardiac surgery for CHD were evaluated.
  • Pre-operative and post-operative assessments (≥1 year) were conducted.
  • Informed written consent was obtained.

Main Results:

  • The incidence of ADHD one year post-cardiac surgery was 32.6%.
  • Significant associations found between ADHD and post-operative complications, longer cardiopulmonary bypass (CPB) time, aortic cross-clamp time, mechanical ventilation duration, ICU stay, and hospital stay.
  • Predictive accuracy for ADHD was moderate to good with CPB time >58 min, aortic cross-clamp time >46 min, hospital stay >8 days, and ICU stay ≥3 days.

Conclusions:

  • ADHD is a frequent outcome after pediatric cardiac surgery.
  • Perioperative factors, especially surgical complexity and recovery markers, are linked to ADHD.
  • Early identification of at-risk children may mitigate long-term morbidity, pending further validation.
Abstract

Keywords:
ADHDADHD (attention deficit and hyperactivity disorder)cardiac surgerycongenital heart diseaseneurodevelopment

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