Controlled study of preschool development after surgery for congenital heart disease
Jo Wraya, Tom Senskyb
a Paediatric Surgical
Unit, Harefield Hospital, Harefield, Middlesex UB9 6JH, UK, b Imperial College School of Medicine, West
Middlesex University Hospital, Isleworth, Middlesex TW7 6AF, UK
Correspondence to: Dr Wray.
Accepted 11
December 1998
AIM
Research into
intellectual impairment among children with congenital heart disease
has focused mainly on older children. This study was designed to
determine whether previous findings are applicable to preschool children.
METHODSThree groups
of children under 31/2 years old were
assessed immediately before treatment and 12 months later: a group with
congenital heart disease awaiting surgery, another awaiting bone marrow
transplantation, and a healthy comparison group.
RESULTSAlthough the
means of the three groups were within the normal range, preoperatively
the cardiac and transplant groups showed deficits compared with the
healthy controls. Postoperatively, continuing developmental deficits
were significant only in the children with cyanotic lesions.
CONCLUSIONSConclusions
about intellectual development in older children with congenital heart
disease do not apply to preschool children. Before corrective surgery,
chronic illness itself appears to be the predominant influence on
development. Postoperatively, cyanotic and acyanotic lesions are
associated with different short term outcomes.
Keywords: congenital heart disease; cardiac surgery; development
© 1999 by Archives of Disease in Childhood
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