Neurodevelopmental Outcomes After Cardiac Surgery in Infancy

Authors

• J. William Gaynor, The Children’s Hospital of Philadelphia
• Christian Stopp, Boston Children’s Hospital
• David Wypij, Boston Children’s Hospital
• Dean B. Andropoulos, Texas Children’s Hospital
• Joseph Atallah, Stollery Children’s Hospital
• Andrew M. Atz, Medical University of South Carolina
• John Beca, Starship Children’s Hospital
• Mary T. Donofrio, Children’s National Medical Center
• Kim Duncan, Children’s Hospital and Medical Center
• Nancy S. Ghanayem, Medical College of Wisconsin
• Caren S. Goldberg, Mott’s Children’s Hospital
• Hedwig Hövels-Gürich, University Hospital Aachen
• Fukiko Ichida, Toyama University Hospital
• Jeffrey P. Jacobs, Johns Hopkins All Children’s Heart Institute
• Robert Justo, University of Queensland
• Beatrice Latal, University Children’s Hospital Zurich
• Jennifer S. Li, Duke University Medical Center
• William T. Mahle, Children’s Healthcare of Atlanta
• Patrick S. McQuillen, University of California
• Shaji C. Menon, Primary Children’s Medical Center
• Victoria L. Pemberton, National Heart, Lung, and Blood Institute
• Nancy A. Pike, Children’s Hospital Los Angeles
• Christian Pizarro, Alfred I. duPont Hospital for Children
• Lara S. Shekerdemian, The Royal Children’s Hospital
• Anne Synnes, University of British Columbia
• Ismee Williams, New York-Presbyterian Morgan Stanley Children’s Hospital of New York
• David C. Bellinger, Boston Children’s Hospital
• Jane W. Newburger, Boston Children’s Hospital

Date of this Version

4-2015

Citation

Pediatrics Vol. 135 No. 5 May 1, 2015, pp. 816 -825 (doi: 10.1542/peds.2014-3825).

Comments

U.S. government work.

Abstract

BACKGROUND: Neurodevelopmental disability is the most common complication for survivors of surgery for congenital heart disease (CHD).

METHODS: We analyzed individual participant data from studies of children evaluated with the Bayley Scales of Infant Development, second edition, after cardiac surgery between 1996 and 2009. The primary outcome was Psychomotor Development Index (PDI), and the secondary outcome was Mental Development Index (MDI).

RESULTS: Among 1770 subjects from 22 institutions, assessed at age 14.5 +/- 3.7 months, PDIs and MDIs (77.6 +/- 18.8 and 88.2 +/- 16.7, respectively) were lower than normative means (each PCONCLUSIONS: Early neurodevelopmental outcomes for survivors of cardiac surgery in infancy have improved modestly over time, but only after adjustment for innate patient risk factors. As more high-risk CHD infants undergo cardiac surgery and survive, a growing population will require significant societal resources.