A New Look at Outcomes of Infants With Congenital Heart Disease

Majnemer, Annette; Limperopoulos, Catherine; Shevell, Michael I.; Rohlicek, Charles; Rosenblatt, Bernard; Tchervenkov, Christo

doi:10.1016/j.pediatrneurol.2008.09.014

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Volume 40, Issue 3 , Pages 197-204, March 2009

A New Look at Outcomes of Infants With Congenital Heart Disease

Annette Majnemer, PhD, OT
- School of Physical and Occupational Therapy, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
- Department of Neurology & Neurosurgery, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
- Communications should be addressed to: Dr. Majnemer; Division of Pediatric Neurology; Montreal Children's Hospital; 2300 Tupper, Room A-509; Montreal, Quebec, H3H 1P3; Canada.
Catherine Limperopoulos, PhD, OT
- School of Physical and Occupational Therapy, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
- Department of Neurology & Neurosurgery, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
Michael I. Shevell, MDCM
- Department of Neurology & Neurosurgery, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
Charles Rohlicek, MDCM
- Department of Pediatrics, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
Bernard Rosenblatt, MDCM
- Department of Neurology & Neurosurgery, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada
Christo Tchervenkov, MDCM
- Department of Cardiovascular Surgery, McGill University, Montreal Children's Hospital–McGill University Health Centre, Montreal, Quebec, Canada

Received 14 May 2008; accepted 7 August 2008.

This article provides an overview of a longitudinal study on a cohort of 131 newborns and young infants with congenital heart defects who required open heart surgery. The rationale for the study design is provided as well as a summary of the procedures used to evaluate these children prior to surgery, at discharge after surgery, 12-18 months later, and at 5 years of age. Results demonstrate that a substantial proportion of these infants had neurologic and developmental abnormalities prior to surgical repair. Developmental delays were common in children with both cyanotic and acyanotic heart defects, and these deficits persisted to school entry. A number of medical, surgical, demographic and environmental factors were significantly associated with developmental outcomes suggesting a multifactorial etiology to brain injury. Limited educational and rehabilitation resources for this cohort at early school age suggests that service needs may need to be more carefully planned for this high-risk population. Lessons learnt from this prospective study are highlighted as well as future directions for research and clinical practice.