Early Neurodevelopmental Outcomes After Corrective Cardiac Surgery In Infants

Indian Pediatr. 2018 May 15;55(5):400-404.

Abstract

Objective: To assess neurodevelopmental status in Indian infants undergoing corrective surgery for congenital heart disease (CHD) and to analyze factors associated with neurodevelopmental delay.

Design: Cross-sectional study.

Setting: Tertiary-care pediatric cardiology facility.

Participants: Consecutive infants undergoing corrective surgery for CHD (January 2013 -December 2014). Palliative procedures, and patients with known genetic syndromes were excluded.

Main outcome measures: Neurodevelopmental evaluation 3 months, and one year after surgery using Developmental Assessment Scales for Indian Infants (DASII); scores were categorized as delayed if ≤70.

Results: Of the 162 children enrolled, delayed PDI and MDI scores were observed in 33.5% and 19.6% of patients at 3 months, respectively; this reduced to 14.5%on 1-year follow-up. On multivariate analysis, delayed PDI outcome at one year was predicted by early term birth and one-year postoperative head circumference Z-score <-2. Delayed MDI was associated with higher mean perfusion pressure on cardiopulmonary bypass. Cardiac diagnosis and peri-operative factors did not impact neurodevelopmental outcomes.

Conclusions: Neurodevelopmental status is delayed in 14.5% of infants one year after corrective infant heart surgery.

Publication types

  • Clinical Trial

MeSH terms

  • Cardiac Surgical Procedures*
  • Cross-Sectional Studies
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology
  • Developmental Disabilities / etiology*
  • Female
  • Heart Defects, Congenital / surgery*
  • Humans
  • India
  • Infant
  • Male
  • Neurodevelopmental Disorders / diagnosis
  • Neurodevelopmental Disorders / epidemiology
  • Neurodevelopmental Disorders / etiology*
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Prospective Studies
  • Risk Factors