title: Neuropsychological and Psychiatric Outcomes in Dextro-Transposition of the Great Arteries across the Lifespan: A State-of-the-Art Review.
abstract: Advances in prenatal diagnosis, perioperative management, and postoperative care have dramatically increased the population of survivors of neonatal and infant heart surgery. The high survival rate of these patients into adulthood has exposed the alarming prevalence of long-term neuropsychological and psychiatric morbidities. Dextro-transposition of the great arteries (d-TGA) is one of the most extensively studied cyanotic congenital heart defect (CHD) with regard to neurodevelopmental outcomes. Landmark studies have described a common neurodevelopmental and behavioral phenotype associated with d-TGA. Children with d-TGA display impairments in key neurocognitive areas, including visual-spatial and fine motor abilities, executive functioning, processing speed, and social cognition. As they grow older, they may face additional challenges with a worsening of deficits in higher order cognitive skills, problems in psychosocial adjustment and a higher-than-expected rate of psychiatric disorders, such as attention-deficit hyperactivity disorder, depression, and anxiety. The aim of this review is to summarize the available recent data on neuropsychological and psychiatric outcomes in individuals with d-TGA after the arterial switch operation. We present findings within a life-span perspective, with a particular emphasis on the emerging literature on adolescent and young adult outcomes. Finally, we propose avenues for future research in the CHD adult neuropsychology field. Among these avenues, we explore the potential mechanisms by which pediatric neurodevelopmental impairments may have lifelong adverse effects as well as alternative interventions that could optimize outcomes.
authors.affiliation: Laboratory of Psychopathology and Neuropsychology, Department of Psychology, University Paris 8, Paris Lumières - CNRS , Saint-Denis , France.
authors.forename: Leila
authors.initials: L
authors.lastname: Kasmi
authors.affiliation: Referral Center for Complex Congenital Cardiac Malformations, Department of Congenital and Pediatric Cardiology, Necker Hospital, University Paris Descartes, Sorbonne Paris Cité , Paris , France.
authors.forename: Damien
authors.initials: D
authors.lastname: Bonnet
authors.affiliation: Laboratory of Psychopathology and Neuropsychology, Department of Psychology, University Paris 8, Paris Lumières - CNRS , Saint-Denis , France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Montreuil
authors.affiliation: Division of Cardiac, Thoracic, and Vascular Surgery, Section of Pediatric Cardiac Surgery, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Irving Medical Center, Columbia University , New York, NY , USA.
authors.forename: David
authors.initials: D
authors.lastname: Kalfa
authors.affiliation: Laboratory of Psychopathology and Neuropsychology, Department of Psychology, University Paris 8, Paris Lumières - CNRS , Saint-Denis , France.
authors.forename: Nikoletta
authors.initials: N
authors.lastname: Geronikola
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Bellinger
authors.affiliation: Department of Psychiatry, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
authors.forename: Johanna
authors.initials: J
authors.lastname: Calderon
keywords: cognitive; dextro-transposition of the great arteries; executive function; neuropsychological outcomes; open-heart surgery; psychiatric disorders