Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .
Prospective follow-up study of children with univentricular heart: neurodevelopmental outcome at age 12 months.
OBJECTIVES Despite recent advances in the treatment of children with univentricular heart , their neurodevelopmental outcome remains a major concern . METHODS This prospect i ve follow-up study evaluated the neurodevelopmental outcome of 23 patients with hypoplastic left heart syndrome , 14 with other forms of univentricular heart , and 46 healthy control subjects at a median age of 12.2 months . The  Griffiths Developmental Scale and Alberta Infant Motor Scale  served for developmental evaluation . RESULTS The mean Griffiths developmental quotient of children with hypoplastic left heart syndrome was significantly less ( 91.6 ) than that of control children ( 106.8 , P < .001 ) . Patients with univentricular heart scored significantly lower than control subjects only in the gross motor domain ( P = .001 ) but not in overall development ( 100.6 ) . Alberta Infant Motor Scale scores were significantly lower in children with hypoplastic left heart syndrome ( 37.5 , P < .001 ) and univentricular heart ( 43.5 , P = .011 ) than in control subjects ( 53.3 ) . In linear regression a diagnosis of hypoplastic left heart syndrome ( P = .016 ) , a clinical history of seizure ( P = .002 ) , and the highest plasma lactate level after the bidirectional Glenn operation ( P = .045 ) were significantly associated with the developmental quotient . CONCLUSIONS At age 1 year , the level of development of children with univentricular heart was significantly lower than for control subjects only in motor skills , whereas children with hypoplastic left heart syndrome had a more widespread developmental delay . The diagnosis , a clinical seizure history , and increased plasma lactate levels after the bidirectional Glenn operation emerged as risk factors
Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .