Mild cognitive deficits seen after heart surgery

Children who undergo surgery to correct congenital heart defects may experience mild learning difficulties when they enter elementary school, according to study findings published in the Journal of Pediatrics.

As advances have been made in the surgical treatment of children with congenital heart disease, developmental outcomes have become the major focus of research, note Dr. Marijke Miatton and colleagues from Ghent University, Belgium.

In their study, the researchers examined 43 children who had congenital heart disease and were an average of nine years old, who were matched to 43 healthy children. An abbreviated intelligence scale (Wechsler Intelligence Scale for Children) and a developmental neuropsychological assessment battery were used to evaluate the children.

The intelligence scale included two verbal subtests and two performance subtests; and the developmental battery tested neuropsychological development in five functional areas.

Compared with the healthy children, the children with congenital heart disease had statistically significant lower IQ scores - 107.0 vs 95.6, respectively. They also scored significantly lower on the Picture Completion and Vocabulary sections of the Wechsler scale.

Miatton's team observed that on the developmental battery the children with congenital heart disease had lower scores in the cognitive areas of Sensorimotor Functioning, Language, Attention and Executive Functioning, and Memory. Children with congenital heart disease also showed more impulsive behavior than the healthy children.

Summing up the results, the researchers conclude that between 6 and 12 years after surgery, children with congenital heart disease have primarily mild motor deficits and subtle difficulties with language tasks. The areas of attention, memory and executive functioning (the ability to absorb, interpret and make decisions based on information provided) also appear to be involved, but to a lesser degree.

Miatton and colleagues point out that this information may lead to learning programs that are tailored to the needs of these children that will significantly improve their outcomes.

SOURCE: Journal of Pediatrics, July 2007.