Neurological evaluation and intelligence testing in the child with operated congenital heart disease

Background. The immediate and intermediate-term neurodevelopmental outcome in infants undergoing open heart procedures using deep hypothermic cardiopu lmonary bypass was assessed prospectively. Methods. One hundred consecutive infants (age 2 to 174 days) were operated on using either deep hypothermic bypass only (group A, n = 28), or with ass ociated circulatory arrest (group B, n = 72). Early neurological outcome wa s recorded. Survivors underwent mental development evaluation after 31 to 5 5 months. Fifty other children of similar demographic profile but without h eart disease were also tested as controls. Results. In group A, there were two neurological deaths. In group B, 5 pati ents had clinical seizures, 1 had monoparesis and 1 had hyperkinetic syndro me with decreased attention span. Mean mental performance quotient was 90.0 +/- 8.2 in group A, and 89.1 +/- 6.8 in group B, (group A vs. B, p = 0.60) . Mean mental performance quotient in the control group was 101.4 +/- 8.4, which was significantly higher than the patient population (p much less tha n 0.001). No correlation was found between duration of circulatory arrest a nd postoperative mental performance quotient. Conclusions. There was significant retardation of mental development in inf ants operated with deep hypothermic cardiopulmonary bypass. However, use of total circulatory arrest and its duration did not affect clinical outcome up to preschool age. (C) 2000 by The Society of Thoracic Surgeons.