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Long-Term Behavior and Quality of Life After Corrective Cardiac Surgery in Infancy for Tetralogy of Fallot or Ventricular Septal Defect

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Abstract

The objective of this study was to evaluate behavior and quality of life in children after corrective cardiac surgery in infancy. Twenty cyanotic (tetralogy of Fallot) and 20 acyanotic children (ventricular septal defect), operated at a mean age of 0.7 years with deep hypothermic circulatory arrest (DHCA) and low-flow cardiopulmonary bypass (CPB), were assessed at a mean age of 7.4 years by the Child Behavior Checklist (CBCL) and the German KINDL. Test results were related to perioperative and neurodevelopmental outcome. Compared to healthy children and not significantly different between the groups, internalizing and externalizing problems were elevated, school performance and total competence were reduced, and self- and parent-reported quality of life was not reduced. Parent-reported problems and reduced physical status were correlated with longer durations of DHCA and CPB. Internalizing and externalizing problems, reduced school competence, and reduced self-esteem were associated with reduced endurance capacity. Externalizing problems were related to reduced gross motor function. Poor school competence was related to reduced intelligence and academic achievement. Children with preoperative hypoxemia in infancy due to cyanotic cardiac defects are not at significantly higher risk for behavioral problems and reduced quality of life than those with acyanotic heart defects. The risk of long-term psychosocial maladjustment after corrective surgery in infancy is increased compared to that for normal children and related to the presence of neurodevelopmental dysfunction.

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Acknowledgments

This study was supported by grants from Bundesverband Herzkranke Kinder e.V. and Herzkrankes Kind Aachen e.V., Aachen, Germany.

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Aachen University of Technology, Pauwelsstrasse 30, 52057, Aachen, Germany

    H. H. Hövels-Gürich, D. Skorzenski & M.-C. Seghaye

  2. Department of Child and Adolescent Psychiatry, Aachen University of Technology, Pauwelsstrasse 30, 52057, Aachen, Germany

    K. Konrad & B. Herpertz-Dahlmann

  3. Institute for Medical Statistics ‘Input,’, 52057, Aachen, Germany

    R. Minkenberg

  4. Department of Thoracic and Cardiovascular Surgery, Aachen University of Technology, Pauwelsstrasse 30, 52057, Aachen, Germany

    B. J. Messmer

Authors
  1. H. H. Hövels-Gürich
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  2. K. Konrad
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  3. D. Skorzenski
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  4. R. Minkenberg
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  5. B. Herpertz-Dahlmann
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  6. B. J. Messmer
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  7. M.-C. Seghaye
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Correspondence to H. H. Hövels-Gürich.

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Hövels-Gürich, H., Konrad, K., Skorzenski, D. et al. Long-Term Behavior and Quality of Life After Corrective Cardiac Surgery in Infancy for Tetralogy of Fallot or Ventricular Septal Defect. Pediatr Cardiol 28, 346–354 (2007). https://doi.org/10.1007/s00246-006-0123-z

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  • DOI: https://doi.org/10.1007/s00246-006-0123-z

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