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 .
Neurodevelopmental outcome related to cerebral risk factors in children after neonatal arterial switch operation
BACKGROUND Neurodevelopmental outcome after  neonatal arterial switch operation for complete transposition of the great arteries is an important topic needing prospect i ve assessment . METHODS A group of 33 unselected children ( 3.0 to 4.6 years ) operated on as neonates with combined deep hypothermic circulatory arrest and low flow cardiopulmonary bypass and a control group of 32 age-matched healthy children ( 3.0 to 4.8 years )  underwent evaluation of socioeconomic and clinical neurological status and a st and ardized test comprising all areas of child development . Results of patients were related to those of the control group , to population norms , and to preoperative , perioperative , and postoperative cerebral risk factors . RESULTS Clinical neurological status was normal in 26 patients ( 78.8 % ) and reduced in 7 ( 21.2 % ) . Complete developmental score and the subscores for motor function , visual perception , learning and memory , cognitive function , language , and socioemotional functions were not different compared to population norms . Compared to the patients , the children of the control group scored higher on tests of complete development , cognition , and language , but also on socioeconomic status . Complete developmental score and the scores for motor , cognitive , and language functions were weakly inversely related to the duration of circulatory arrest , but not to the duration of bypass . Cerebral risk factors such as serum levels of the neuron-specific enolase , perinatal acidosis , perinatal asphyxia , peri- and postoperative cardiocirculatory insufficiency , or clinical seizures were not correlated to the test results . CONCLUSIONS Neonatal arterial switch operation with combined circulatory arrest and low flow bypass is associated with neurological impairment , but not with reduced development as assessed by formal testing of motor , cognitive , language , and behavioral functions . Perioperative serum level of the neuron-specific enolase is not a valid marker for later developmental impairment
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 .