title: Neurodevelopmental outcome following open heart surgery in infancy: 6-year follow-up.
abstract: BACKGROUND
  Children undergoing open heart surgery are at risk of neurological injury. A cohort of 35 patients, who had undergone cardiac surgery during infancy, had a significant reduction in Bayley Scale of Infant Development scores at a 12-month assessment. This cohort has now reached an appropriate age to reassess developmental progress.
  
  
  METHODS
  Detailed psychometric testing was conducted on 20 children from the original cohort using the Weschler Preschool and Primary Scale of Intelligence, the Wide Range Assessment of Memory and Learning, and the Wechsler Individual Achievement Test. Parents completed the Connor's Rating Scale, the Behaviour Rating Scale of Executive Functioning, and the Child Behaviour Checklist.
  
  
  RESULTS
  The mean age of the cohort at assessment was 6.6 (standard deviation 0.4) years. Mean scores on all tests of intelligence, memory, academic achievement, and executive function fell within the average range. Of the children, 20-35% were found to have significant difficulties across these areas. Mean scores in the areas of social, emotional, behavioural, and psychological functioning also fell within the average range. Of the children studied, 35% had clinically significant problems in these areas. There was only a weak association between the 12-month scores and the Full-Scale Intelligence Quotient at 6 years.
  
  
  CONCLUSIONS
  Detailed psychometric testing of these children suggests that they generally function in the average range; however, a significant proportion falls below age expectations in all the areas assessed. This highlights the importance of long-term follow-up with routine developmental screening to allow identification of a subgroup that may benefit from early educational and behavioural intervention.
authors.affiliation: 1Department of Cardiology,The Royal Children's Hospital,Melbourne,Australia.
authors.forename: Bryn
authors.initials: B
authors.lastname: Jones
authors.affiliation: 3Murdoch Children's Research Institute,Melbourne,Australia.
authors.forename: Frank
authors.initials: F
authors.lastname: Muscara
authors.affiliation: 4Queensland Paediatric Rehabilitation Service,Royal Children's Hospital,Brisbane,Australia.
authors.forename: Owen
authors.initials: O
authors.lastname: Lloyd
authors.affiliation: 4Queensland Paediatric Rehabilitation Service,Royal Children's Hospital,Brisbane,Australia.
authors.forename: Lynne
authors.initials: L
authors.lastname: McKinlay
authors.affiliation: 5Queensland Paediatric Cardiac Service,Mater Health Services,Brisbane,Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Justo
mesh_terms: D006348:Cardiac Surgical Procedures; D002657:Child Development; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D065886:Neurodevelopmental Disorders / Q000175:diagnosis*; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011594:Psychometrics
keywords: Heart defects; congenital; developmental outcome; paediatric cardiac surgery