Abstract
Objective: To identify risk factors that affect the neuropsychological development of young children who have undergone radical correction of congenital heart disease in infancy and the newborn period.
Material and methods. Our study is a single-center prospective study of children with three groups of common congenital heart disease: transposition of general arteria (TGA), tetralogy of Fallot (TOF), and ventricular septal defect (VSD). From 2017 to 2018, more than 200 radical surgical interventions for these congenital heart disease were performed in the Federal Center for Cardiovascular Surgery, Russian Federation (Penza). 25 patients who were observed in the polyclinic were selected sequentially at random. The median age at the time of surgery was 91 days, including 9 newborns. Neuro-psychological development was assessed no earlier than one year after the surgery using the 2nd edition of the Bailey scale (BSID-II).
Results. Risk factors that affect the neuropsychological development of children after cardiac surgery were studied: low birth weight, male gender, age at the time of surgery, severity of hypoxemia before surgery, duration of IC, aortic compression, being on a ventilator, the need for inotropic support, and time spent in the ICU. There was a slight but statistically significant delay in motor skills in children with “blue” CHD – TOF and TGA (OR 11.9; 95% confidence interval (CI) 1.2–23.2; p=0.025). A lower value of the psychomotor development index (PDI) was also determined in comparison with the intellectual development index (MDI), regardless of the type of CHD. There was no early or long-term postoperative mortality.
Conclusion. Risk factors that affect the neuropsychological development of children after cardiac surgery were studied: low birth weight, male gender, age at the time of surgery, severity of hypoxemia before surgery, duration of IC, aortic compression, being on a ventilator, the need for inotropic support, and time spent in the ICU. There was a slight but statistically significant delay in motor skills in children with “blue” CHD – TOF and TGA (OR 11.9; 95% confidence interval (CI) 1.2–23.2; p=0.025). A lower value of the psychomotor development index (PDI) was also determined in comparison with the intellectual development index (MDI), regardless of the type of CHD. There was no early or long-term postoperative mortality.
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About the authors
- Vladlen V. Bazylev, Dr. Med. Sc., Chief Physicion, ORCID
- Igor' E. Chernogrivov, Dr. Med. Sc., Cardiovascular Surgeon, ORCID
- Alishir B.O. Gamzaev, Dr. Med. Sc., Professor, ORCID
- Irina S. Nazarova, Pediatric Cardiologist, ORCID
- Tat'yana V. Rybakova, Pediatric Cardiologist, ORCID
- Aleksey E. Chernogrivov, Dr. Med. Sc., Head of Department, ORCID
