NEURODEVELOPMENTAL OUTCOMES IN CHILDREN WITH FONTAN REPAIR OF FUNCTIONAL SINGLE VENTRICLE

Objectives. The purpose of this study was to assess the neurodevelopme ntal status of children after Fontan repair of functional single ventr icle and to examine the relationship between cognitive function and se lected patient characteristics. Study Design. Neurodevelopmental tests including the Stanford-Binet Intelligence (IQ) scale and the Developm ental Test of Visual Motor Integration (VMI) were administered to 32 c hildren (26 months to 16 years of age) with complex single ventricle. The mean and distribution of Ig and VMI scores were compared with popu lation norms. The relationship between test scores and patient charact eristics was examined utilizing analysis of variance and correlational methods. Results. The majority of children had intellectual function within the normal range (mean, 97.5 +/- 12.1). Below average VMI score s were found in 21.4% of children. There were no significant correlati ons between intellectual function or visual motor integration ability and preoperative oxygen saturation or age at Fontan. Children who had deep hypothermic circulatory arrest during a prior Norwood procedure t ended to have a lower IQ score. Conclusions. Intellectual development in children with Fontan repair of complex heart defects is essentially within the normal range. Visual motor integration deficits may be mor e prevalent in these children. In our population, the duration and deg ree of preoperative hypoxemia had no apparent effect on cognitive func tion.