Congenital heart disease and cardiac surgery in childhood: effects on cognitive function and academic ability.
OBJECTIVE
To evaluate changes in cognitive and academic functioning following cardiac surgery in children with congenital heart disease.


METHODS
A prospective cross sectional study in which patients were assessed immediately before treatment and 12 months later.


METHODS
Three groups of children aged 3.5-17 years: a group with congenital heart disease awaiting surgery, another awaiting bone marrow transplantation, and a healthy comparison group.


METHODS
Intelligence quotient and measures of academic attainment, evaluated with the British Ability Scales.


RESULTS
Preoperatively, children with cyanotic lesions showed deficits in comparison with those with acyanotic lesions. Postoperatively, children with cyanotic lesions showed a deterioration in performance and achieved significantly lower scores than those with acyanotic lesions. While there were significant differences between the congenital heart disease and bone marrow transplantation groups preoperatively, these were no longer apparent at follow up.


CONCLUSIONS
In contrast to previously published findings, the present results suggest that cardiac surgery does not result in early postoperative improvements in cognitive function for children with congenital heart disease. The nature of the cardiac lesion continues to affect cognitive and academic performance, even after surgery.
Wray
J
J
Paediatric Surgical Unit, Harefield Hospital, Harefield, Middlesex UB9 6JH, UK. j.wray@rbh.nthames.nhs.uk
Sensky
T
T
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000523:psychology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D003490:Cyanosis / Q000523:psychology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012923:Social Class