title: Persistence of visuo-constructional and executive deficits in adolescents after open-heart surgery.
abstract: OBJECTIVE
  This study assesses whether previously reported performance deficiencies in visuo-constructional and executive functions, using the Rey-Osterrieth Complex Figure Test (ROCFT) in pediatric patients with congenital heart disease (CHD), persist into adolescence.
  
  
  METHODS
  53 adolescent CHD patients (mean age 13.7) and 39 healthy controls (mean age 14.1) participated. ROCFT performance was measured by three different scoring methods, focusing either on quantitative (Meyers & Meyers, 1995), qualitative (Wallon & Mesmin, 2009), or both performance aspects (Bernstein & Waber, 1996). Potential confounders (i.e., intelligence and visuomotor integration) and surgery-related risk factors were included in the data analysis.
  
  
  RESULTS
  Adolescents with CHD demonstrated immature copy and recall approaches on the ROCFT using the qualitative system by Wallon and Mesmin (p<.001). Memory performance was also predicted by Bernstein and Waber scores (p<.03), whereas group differences were not significant according to the other scoring methods. Intelligence and visuomotor skills, but not surgery-related risk factors, were positively correlated with ROCFT performance (each p<.02). Interpretation: Visuoconstructional and executive deficiencies could be found in adolescent patients with CHD. However, not all ROCFT scoring methods were equally apt to detect group differences: especially the qualitative scoring method developed by Wallon and Mesmin seems sufficiently sensitive to detect long-lasting visuo-constructional and executive deficiencies in CHD patients.
authors.affiliation: Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Pediatrics, Kantonsspital Winterthur, Brauerstr. 15, 8401 Winterthur, Switzerland. Electronic address: Michael.vonRhein@kispi.uzh.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: von Rhein
authors.affiliation: Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
authors.forename: Julietta
authors.initials: J
authors.lastname: Kugler
authors.affiliation: Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich/Children's Reseach Center, Switzerland.
authors.forename: Rabia
authors.initials: R
authors.lastname: Liamlahi
authors.affiliation: Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich/Children's Reseach Center, Switzerland; Childrens Research Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
authors.forename: Walter
authors.initials: W
authors.lastname: Knirsch
authors.affiliation: Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Childrens Research Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Latal
authors.affiliation: Department of Psychiatry and Psychotherapy A, General Hospital, Milser Straße 10, 6060 Hall in Tyrol, Austria.
authors.forename: Liane
authors.initials: L
authors.lastname: Kaufmann
keywords: Adolescent; Congenital heart defect; Open-heart surgery; ROCFT; Rey figure; Visuo-constructional