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 .
Visual‐Spatial Skills in Children After Open‐Heart Surgery
ABSTRACT . This study was part of a r and omized clinical trial comparing the central nervous system effects of the two vital organ‐support methods used in  infant cardiac surgery : total circulatory arrest and low‐flow cardiopulmonary bypass . The extent to which visual‐spatial deficits are ( 1 ) associated with surgical and perioperative variables , ( 2 ) attributable to visual‐perceptual , motor control , or metacognitive deficits , and ( 3 ) associated with adaptive difficulties at home or school was evaluated . The subjects were 155 8‐year‐old children with D‐transposition of the great arteries who underwent the arterial switch operation before 3 months of age . As part of a comprehensive evaluation , the Rey‐Osterrieth Complex Figure ( ROCF ) was administered . ROCF copy productions were classified as having a Basal Organization Level of 1 ( low ) or 2 or greater . A five‐category clinical rating was also assigned . More than half of the children in the cohort ( 52 % ) had copy productions scored at Level 1 , more than twice the expected frequency . The risk of having a low score was not associated with vital organ support method or other surgical variables . On the basis of comparisons of the relative fits of nested logistic regression models , poor visual‐perceptual abilities were more predictive of having a Level 1 score than either motor control or metacognitive deficits . Children with poor copy production scores had lower mathematics scores , but not lower reading scores or poorer parent and teacher ratings of adaptive competence . The percentage of children receiving remedial school services was associated with ROCF clinical rating , ranging from 58 % in the worst category to 8 % in the best category . Visual‐spatial deficits are common among children after infant heart surgery and seem to reflect visual‐perceptual rather than motor control or metacognitive deficits . In addition , these deficits do not seem to be clearly associated with the intraoperative methods or postoperative events evaluated . J Dev Behav Pediatr 24:169‐179 , 2003 . Index terms : congenital heart disease , visual‐spatial skills , transposition of the great arteries , Rey‐Osterrieth Complex Figure
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 .