Calderon J, et al. – This prospective study was designed to compare the cognitive outcomes in children with operated (open–heart surgery) and non–operated (catheter–based interventions only or no intervention) congenital heart defects (CHD). Investigations revealed that a high proportion of preschool children with CHD with or without surgery were at early cognitive risk, despite of the mean scores within the normative range. Moreover, small for gestational age (SGA) was a strong predictor of the neurodevelopmental prognosis in CHD.

Methods

• With the Kaufman Assessment Battery for Children II, standardised cognitive scores (mean scores and proportions below normative values) were evaluated.
• The demographic, perinatal and operative variables were evaluated as predictors of cognitive outcomes.

Results

• In this study 419 children participated (154 with open–heart surgery; 265 without surgery).
• Between the groups, global cognitive scores did not differ.
• Compared with the non–operated group, children who underwent surgery obtained lower scores in expressive language (p=0.03) and logical reasoning (p=0.05).
• When compared with test norms, the frequency of global cognitive scores >1 SDs below the expected mean was higher in the surgical group (25% vs 16% in the general population) (p=0.03).
• A higher–than–expected proportion of children in the non–operated group scored >2 SDs below the expected mean (7% vs 2%) (p=0.05).
• A higher–than–expected proportion of children in the non–operated group scored >2 SDs below the expected mean (7% vs 2%) (p=0.05).