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 .
Relation of seizures after cardiac surgery in early infancy to neurodevelopmental outcome. Boston Circulatory Arrest Study Group.
BACKGROUND The outcome of infants who have transient seizures after open heart surgery has not been studied . Using the data base of the Boston Circulatory Arrest Study involving 171 children with D-transposition of the great arteries , we explored the relationship between early postoperative clinical and EEG seizures and neurodevelopmental outcomes at ages 1 and 2 1/2 years . METHODS AND RESULTS At 1 year , children returned for developmental and neurological evaluations  and MRI . Parent-completed developmental question naires were collected at 2 1/2 years of age . At 1 year , children with early postoperative seizures had lower Psychomotor Development Index ( motor function ) scores ( clinical seizures : 12.9 mean difference [ MD ] ; 95 % confidence interval [ CI ] , 2.2 to 23.6 ; P=.02 ; EEG seizures : 13.3 MD ; 95 % CI , 6.8 to 19.7 ; P<.001 ) . Mental Developmental Index scores of children with clinical or EEG seizures were also lower , but the differences were not statistically significant . Infants with seizures were more likely to have an abnormal neurological examination ( clinical seizures : 78 % versus 31 % ; P=.008 ; EEG seizures : 58 % versus 34 % ; P=.04 ) . Children with EEG seizures were more likely to have MRI abnormalities ( 43 % versus 13 % , P=.002 ) . At age 2 1/2 , children with EEG seizures had lower scores in several areas of function . CONCLUSIONS In infants undergoing the arterial switch operation for correction of D-transposition of the great arteries , transient postoperative clinical and EEG seizures were associated with worse neurodevelopmental outcomes at ages 1 and 2 1/2 years as well as neurological and MRI abnormalities at 1 year of age . The occurrence of such seizures may provide an early sign of brain injury with neurological and developmental sequelae
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 .