Neurodevelopmental outcome, psychological adjustment, and quality of life in adolescents with congenital heart disease.
OBJECTIVE
The aim of this study was to examine neurodevelopment, psychological adjustment, and health-related quality of life (HRQoL) in adolescents after bypass surgery for congenital heart disease (CHD) during early childhood.


METHODS
Fifty-nine adolescents (34 females, 25 males) with CHD were examined at a median age of 13 years 8 months (range 11 y 5 mo-16 y 11 mo). Outcome was assessed with the Wechsler Intelligence Scale for Children, (fourth edition); the Beery Test of Visual-Motor Integration; the Rey-Osterrieth Complex Figure Test; the Zurich Neuromotor Assessment; the Strengths and Difficulties Questionnaire; and the KIDSCREEN questionnaires. Results were compared with those of 40 age- and sex-matched healthy comparison individuals.


RESULTS
Outcome with regard to full-scale IQ, perceptual reasoning, and the working memory scale was poorer in patients with CHD than in the comparison group (all p ≤ 0.001). Visual perception, visuomotor integration (p ≤ 0.001), and executive functions (Rey figure copy: p=0.05) were also affected. Patients with CHD also had lower scores on all motor domains (p < 0.02) except static balance. Psychological adjustment was affected only in the 'peer relationship' domain (p=0.05). Quality of life was similar to that of typically developing peers.


CONCLUSIONS
Adolescents with CHD may manifest persistent cognitive and motor impairments, while psychological adjustment and self-reported HRQoL are mostly typical. Thus, long-term neurodevelopmental evaluations are necessary to provide early educational and therapeutic support.
Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland.
Christina
C
Schaefer
Michael
M
von Rhein
Walter
W
Knirsch
Reto
R
Huber
Giancarlo
G
Natalucci
Jon
J
Caflisch
Markus A
MA
Landolt
Beatrice
B
Latal
D000223:Adaptation, Psychological / Q000502:physiology*; D000293:Adolescent; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D003210:Concept Formation / Q000502:physiology; D002658:Developmental Disabilities / Q000209:etiology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014888:Wechsler Scales