Neurodevelopmental challenges in adults operated for septal defects in childhood

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Introduction: Neurodevelopmental outcome is impaired in young adults with complex congenital heart disease. It is unknown whether the same holds for atrial (ASD) and ventricular septal defects (VSD). The present study examines the hypothesis of impaired neuropsychological outcome in adults who have undergone corrective surgery for septal defects in early childhood.

Methods: In a prospective, cohort study two groups of participants were enrolled; 1) patients who had undergone corrective surgery for an isolated ASD or VSD in between 1990 and 2000, and 2) healthy controls matched on age, gender, and education level. The Full-Scale IQ and subdomains of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) were employed and patient performances were compared to the control group and the expected population mean.

Results: A total of 21 ASD patients, 22 VSD patients and two groups of each 16 healthy controls were enrolled. Mean age was 27.4 (±6.3) years in the ASD group and 24.2 (±2.7) years in the VSD group. Full-Scale IQ was lower in the ASD group (93.8 ±11.7) compared with the control group (103.9 ±9.9; p= 0.01) and with the expected population mean (100 ±15.0; p= 0.02). The ASD group demonstrated lower performances on the WAIS-IV subdomains: verbal comprehension (91.0 ±14.1; p= 0.01), perceptual reasoning (93.8 ±12.3; p= 0.03) and working memory (91.6 ±12.2; p= 0.005) compared to the expected population mean. Full-scale IQ was not significantly different in the VSD group (95.8 ±15.2) compared with the control group (103.7 ±10.8; p= 0.09) nor with the expected population mean (p= 0.21). However, the VSD group demonstrated lower performances on the WAIS-IV subdomains: verbal comprehension (91.5 ±16.1; p= 0.02) and working memory (91.6 ±13.9; p= 0.01) compared to the expected population mean.

Conclusions: Surgically corrected congenital septal defects may be associated with lower IQ scores in adulthood. Further studies should clarify the extent of these patients’ neurodevelopmental challenges and evaluate targeted interventions to alleviate these long-term effects.
Original languageEnglish
JournalCirculation
Volume138
IssueSuppl 1
Pages (from-to)A14641
ISSN0009-7322
Publication statusPublished - 2018
EventAmerican Heart Association Scientific Sessions 2018 - Mc Cormick Center, Chicago, United States
Duration: 10 Nov 201812 Nov 2018

Conference

ConferenceAmerican Heart Association Scientific Sessions 2018
LocationMc Cormick Center
CountryUnited States
CityChicago
Period10/11/201812/11/2018

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