[III-TSPCJS-02] Neurodevelopmental outcomes in children with congenital heart disease
Keywords:Neurodevelopment, Congenital heart disease, hypoxia
Neurodevelopmental disability is the most common, and potentially the most damaging, complication of patients with CHD who require cardiac surgery in infancy. These children have more problems with reasoning, learning, executive functions, inattention and impulsive behaviors, language skills, and social skills. Lower abilities in these areas may lead to poor school performance, strained interpersonal relationships, and behavior problems. School-aged survivors who had cardiac surgery during infancy are more likely than the general population to require remedial services, including tutoring and special education, as well as physical, occupational and speech therapy. Over the past 15 years, we have performed a regional volumetric study of the brain using three dimensional MRI in infants with CHD. As our previous studies showed, neurodevelopment, as well as brain growth, are limited in children with single ventricle (SV) compared to those with transposition of the great arteries (TGA) because of prolonged hypoxia. Further, a longitudinal prospective study in preschool and school-age children showed that brain growth in SV patients does not catch-up to that in TGA patients or normal controls during school-age. There is a correlation between brain volume and IQ score. In addition, the toddler neurodevelopment index may predict IQ levels and needs for special education services at school-age. It is recommended to provide earlier intervention for toddler with lower developmental score, to enhance later academic and behavioral function at school-age children with SV.