nach oben

Neuropsychology Review

Erschienen in:

01.06.2006 | Original Paper

Neurocognitive Consequences of Surgically Corrected Congenital Heart Defects: A Review

verfasst von: M. Miatton, D. De Wolf, K. François, E. Thiery, G. Vingerhoets

Erschienen in: Neuropsychology Review | Ausgabe 2/2006

Einloggen, um Zugang zu erhalten

Abstract

With advances in surgical procedures, neuropsychological assessment after congenital heart defects and pre, peri- and/or postoperative predictors of adverse outcome has become an important focus in research. We aim to summarize neuropsychological sequelae associated with different types of congenital heart defects, critically review the methodology used in more than 20 empirical studies that were retrieved from biomedical electronic search engines, and identify possible directions for future research. Despite the lack of adequate control groups and long-term studies, there seem to be some cognitive deficits. The largest group of children with isolated congenital heart defects present with normal intellectual capacities. However, they tend to show language deficits and motor dysfunction. Although performances on memory tasks are good, unambiguous conclusions concerning their attentional and executive functioning are still lacking. Serious behavioral problems are not an issue. In addition to a detailed description of the (neuro) psychological consequences of pediatric cardiac surgery, an overview of the predictors of the cognitive defects is provided.

Aldèn, B., Gilljam, T., & Gillberg, C. (1998). Long term psychological outcome of children after surgery for transposition of the great arteries. Acta Paediatrica, 87, 405–410.PubMedCrossRef

Bellinger, D. C., Rappaport, L. A., Wypij, D., Wernovsky, G., & Newburger, J. W. (1997). Patterns of developmental dysfunction after surgery during infancy to correct transposition of the great arteries. Journal of Developmental and Behavioral Pediatrics, 18(2), 75–83.PubMedCrossRef

Bellinger, D. C., Wernovsky, G., Rappaport, L. A., Mayer, J. E., Castaneda, A. R., Farrell, D. M., Wessel, D. L., Lang, P., Hickey, P. R., Jonas, R. A., & Newburger, J. W. (1991). Cognitive development of children following early repair of transposition of the great arteries using deep hypothermic circulatory arrest. Pediatrics, 87(5), 701–707.PubMed

Bellinger, D. C., Wypij, D., du Plessis, A. J., Rappaport, L. A., Riviello, J., Jonas, R. J., & Newburger, J. W. (2001). Developmental and neurologic effects of alpha-stat versus pH-stat strategies for deep hypothermic cardiopulmonary bypass in infants. Journal of Thoracic and Cardiovascular Surgery, 121(2), 374–383.

Bellinger, D. C., Wypij, D., Kuban, K. C. K., Rappaport, L. A., Hickey, P. R., Wernovsky, G., Jonas, R. A., & Newburger, J. W. (1999). Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation, 100(5), 526–532.PubMed

Bruns, L. A., Chrisant, M. K., Lamour, J. M., Shaddy, R. E., Pahl, E., Blume, E. D., Hallowell, S., Addonizio, L. J., & Canter, C. E. (2001). Carvedilol as therapy in pediatric heart failure: An initial multicenter experience. Journal of Pediatrics, 138(4), 505–511.PubMedCrossRef

Colemann, K. (2002). Genetic counseling in congenital heart disease. Critical Care Nursing Quarterly, 25(3), 8–16.

Connolly, D., Rutkowski, M., Auslender, M., & Artman, M. (2001). The New York University Pediatric Heart Failure Index: A new method of quantifying chronic heart failure severity in children. Journal of Pediatrics, 138(5), 644–648.PubMedCrossRef

Dickinson, D. F., & Sambrooks, J. E. (1979). Intellectual performance in children after circulatory arrest with profound hypothermia in infancy. Archives of Disease in Childhood, 54, 1–6.PubMed

Dittrich, H., Bührer, C., Grimmer, I., Dittrich, S., Abdul-Khaliq, H., & Lange, P. E. (2003). Neurodevelopment at 1 year of age in infants with congenital heart disease. Heart, 89(4), 436–441.PubMedCrossRef

Ekroth, R., Thompson, R. J., Lincoln, C., Scallan, M., Rossi, R., & Tsang, V. (1989). Elective deep hypothermia with total circulatory arrest: Changes in plasma creatine kinease BB, blood glucose, and clinical variables. Journal of Thoracic and Cardiovascular Surgery, 97, 30–35.PubMed

Feldt, R. H., Ewart, J. C., Stickler, G. B., & Weidman, W. H. (1969). Children with congenital heart disease. American Journal of Diseases in Children, 117, 281–287.

Forbess, J. M., Visconti, K. J., Bellinger, D. C., Howe, R. J., & Jonas, R. A. (2002). Neurodevelopmental outcomes after biventricular repair of congenital heart defects. Journal of Thoracic and Cardiovascular Surgery, 123(4), 631–639.PubMedCrossRef

Forbess, J. M., Visconti, K. J., Hancock-Friesen, C., Howe, R. C., Bellinger, D. C., & Jonas, R. A. (2002). Neurodevelopmental outcome after congenital heart surgery: Results from an institutional registry. Circulation, 106(13), I95–I102.PubMed

Gaynor, J. W., Gerdes, M., Zackai, E. H., Bernbaum, J., Wernovsky, G., Clancy, R. R., Newman, M. F., Saunders, A. M., Heagerty, P. J., D’Agostino, J. A., McDonald-McGinn, D., Nicolson, S. C., Spray, T. L., & Jarvik, G. P. (2003). Apolipoprotein E genotype and neurodevelopmental sequelae of infant cardiac surgery. Journal of Thoracic and Cardiovascular Surgery, 126, 1736–1745.PubMedCrossRef

Hamrick, S. E. G., Gremmels, D. B., Keet, C. A., Leonard, C. H., Connell, J. K., Hawgood, S., & Piecuch, R. E. (2003). Neurodevelopmental outcome of infants supported with extracorporeal membrane oxygenation after cardiac surgery. Pediatrics, 111(6), E671–E675.PubMedCrossRef

Haneda, K., Itoh, T., Togo, T., Ohmi, M., & Mohri, H (1996). Effects of cardiac surgery on intellectual function in infants and children. Cardiovascular Surgery, 4(3), 303–307.PubMedCrossRef

Hoffman, J. I., & Kaplan, S. (2002). The incidence of congenital heart disease. Journal of American College of Cardiology, 39,1890–1900.CrossRef

Hövels-Gürich, H. H., Seghaye, M. C., Däbritz, S., Messmer, B. J., & von Bernuth, G. (1997). Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. Journal of Thoracic and Cardiovascular Surgery, 114(4), 578–585.

Hövels-Gürich, H. H., Seghaye, M. C., Schnitker, R., Wiesner, M., Huber, W., Minkenberg, R., Kotlarek, F., Messmer, B. J., & von Bernuth, G. (2002). Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation. Journal of Thoracic and Cardiovascular Surgery, 124(3), 448–458.

Hövels-Gürich, H. H., Seghaye, M. C., Sigler, M., Kotlarek, F., Bartl, A., Neuser, J., Minkenberg, R., Messmer, B. J., & von Bernuth, G. (2001). Neurodevelopmental outcome related to cerebral risk factors in children after neonatal arterial switch operation. Annals of Thoracic Surgery, 71(3), 881–888.PubMedCrossRef

Jonas, R. A., Wypij, D., Roth, S. J., Bellinger, D. C., Visconti, K. J., du Plessis, A. J. Goodkin, H., Laussen, P. C., Farrell, D. M., Bartlett, J., McGrath, E., Rappaport, L. J., Bacha, E. A., Forbess, J. M., & del Nido, P. (2003). The influence of hemodilution on outcome after hypothermic cardiopulmonary bypass: results of a randomized trial in infants. Journal of Thoracic and Cardiovascular Surgery, 126, 1764–1774.

Kern, J. H., Hinton, V. J., Nereo, N. E., Hayes, C. J., & Gersony, W. M. (1998) Early developmental outcome after the Norwood procedure for hypoplastic left heart syndrome. Pediatrics, 102(5), 1148–1152.

Kirkham, F. J. (1998). Recognition and prevention of neurological complications in pediatric cardiac surgery. Pediatric Cardiology, 19, 331–345.PubMedCrossRef

Lewis, F. J., & Taufic, M. (1953). Closure of atrial septal defects with the aid of hypothermia: Experimental accomplishments and the report of one successful case. Surgery, 32, 52–59.

Limperopoulos, C., Majnemer, A., Shevell, M. I., Rohlicek, C., Rosenblatt, B., Tchervenkov, C., & Darwish, H. Z. (2002). Predictors of developmental disabilities after open-heart surgery in young children with congenital heart defects. Journal of Pediatrics, 141(5), 51–58.PubMed

Limperopoulos, C., Majnemer, A., Shevell, M. I., Rosenblatt, B., Rohlicek, C., & Tchervenkov, C. (1999). Neurologic status of newborns with congenital heart defects before open-heart surgery. Pediatrics, 103(2), 402–408.PubMedCrossRef

Linde, L. M., Rasof, B., & Dunn, O. (1967). Mental development in congenital heart disease. Journal of Pediatrics, 71, 198–203.PubMedCrossRef

Mahle, W. T., Clancy, R. R., Moss, E. M., Gerdes, M., Jobes, D. R., & Wernovsky, G. (2000). Neurodevelopmental outcome and lifestyle assessment in school-aged and adolescent children with hypoplastic left heart syndrome. Pediatrics, 105(5), 1082–1089.PubMedCrossRef

Mahle, W. T., Spray, T. L., Wernovsky, G., Gaynor, J. W., & Clark, B. J. (2000). Survival after reconstructive surgery for hypoplastic left heart syndrome: a 15-year experience from a single institution. Circulation, 102, III136—III141.

Mahle, W. T., Tavani, F., Zimmerman, R. A., Nicolson, S. C., Galli, K. K., Gaynor, W., Clancy, R. R., Montenegro, L. M., Spray, T. L., Chiavacci, R. M., Wernovsky, G., & Kurth, C. D. (2002). An MRI study of neurological injury before and after congenital heart surgery. Circulation, 106(suppl I), I109–I114.

May, L. E. (2001). Pediatric Heart Surgery: A ready reference for professionals. 2nd edn. Milwaukee, Wis: Maxishare.

McConnell, J. R., Fleming, W. H., Chu, W. K., Hahn, F. J., Sarafan, L. B., Hofschire, P. J., & Kugler, J. D. (1990). Magnetic resonance imaging of the brain in infants and children before and after cardiac surgery. A prospective study. American Journal of Diseases in Children, 144(3), 374–378.

Miller, G., & Vogel, H. (1999). Structural evidence of injury or malformations in the brains of children with congenital heart disease. Seminars in Pediatric Neurology, 6, 20–26.PubMedCrossRef

Miller, G., Tesman, J. R., Ramer, J. C., Baylen, B. G., & Myers, J. L. (1996). Outcome after open-heart surgery in infants and children. Journal of Child Neurology, 11, 49–53.PubMed

Newburger, J. W., Jonas, R. A., Wernovsky, G., Wypij, D., Hickey, P. R., Kuban, K. C. K., Farrell, D. M., Holmes, G. L., Helmers, S. L., Constantinou, J., Carrazana, E., Barlow, J. K., Walsh, A. Z., Lucius, K. C., Share, J. C., Wessel, D. L., Hanley, F. L., Mayer, J. E., Castaneda, A. R., & Ware, J. H. (1993). A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart-surgery. New England Journal of Medicine, 329(15), 1057–1064.PubMedCrossRef

Newburger, J. W., Wypij, D., Bellinger, D. C., du Plessis, A. J., Kuban, K. C. K., Rappaport, L. A., Almirall, D., Wessel, D. L., Jonas, R. A., & Wernovsky, G. (2003). Length of stay after infant heart surgery is related to cognitive outcome at age 8 years. Journal of Pediatrics, 143, 67–73.PubMedCrossRef

Nuutinen, M., Koivu, M., & Rantakallio, P. (1989). Long-term outcome for children with congenital heart defects. Arctic Medical Research, 48, 175–184.PubMed

O’Dougherty, M., Wright, F. S., Garmezy, N., Lowenson, R. B., & Torres, F. (1983). Later competence and adaptation in infants who survive severe heart defects. Child Development, 54, 1129–1142.PubMedCrossRef

O’Dougherty, M., Wright, F. S., Loewenson, R. B., & Torres, F. (1985). Cerebral dysfunction after chronic hypoxia in children. Neurology, 35, 42–46.PubMed

Oates, R. K., Simpson, J. M., Cartmill, T. B., & Turnbull, J. A. B. (1995a). Intellectual function and age of repair in cyanotic congenital heart disease. Archives of Disease in Childhood, 72(4), 298–301.PubMed

Oates, R. K., Simpson, J. M., Turnbull, J. A. B., & Cartmill, T. B. (1995 b) The relationship between intelligence and duration of circulatory arrest with deep hypothermia. Journal of Thoracic and Cardiovascular Surgery, 110(3), 786–792.PubMedCrossRef

Rappaport, L. A., Wypij, D., Bellinger, D. C., Helmers, S. L., Holmes, G. L., Barnes, P. D., Wernovsky, G., Kuban, K. C. K., Jonas, R. A. & Newburger, J. W. (1998). Relation of seizures after cardiac surgery in early infancy to neurodevelopmental outcome. Circulation, 97, 773–779.PubMed

Rasof, B., Linde, L. M., & Dunn, O. (1967). Intellectual development in children with congenital heart disease. Child Development, 38, 1043–1053.PubMedCrossRef

Rogers, B. T., Msall, M. E., Buck, G. M., Lyon, N. R., Norris, M. K., Roland, J. M. A., Gingell, R. L., Cleveland, D. C., & Pieroni, D. R. (1995). Neurodevelopmental outcome of infants with hypoplastic left heart syndrome. Journal of Pediatrics, 126(3), 496–498.PubMedCrossRef

Rosenthal, A. (1967). Visual simple reaction time in cyanotic heart disease. American Journal of Diseases in Children, 114, 139–143.

Rossi, R., Ekroth, R., Lincoln, C., Jackson, A. P., Thompson, R. J., Scallan, M., & Tsang, V. (1986). Detection of cerebral injury after total circulatory arrest and profound hypothermia by estimation of specific creatine kinase isoenzyme levels using monoclonal antibody techniques. American Journal of Cardiology, 58(13), 1236–1241.PubMedCrossRef

Rossi, R., vander Linden, J., Ekroth, R., Scallan, M., Thompson, R. J., & Lincoln, C. (1989). No flow or flow: a study of ischemic marker creatine kinase BB after deep hypothermic procedures. Journal of Thoracic and Cardiovascular Surgery, 98, 193–199.PubMed

Scallan, M. J. H. (2003). Brain injury in children with congenital heart disease. Paediatric Anesthesia, 13, 284–293.CrossRef

Sharma, R., Choudhary, S. K., Mohan, M. R., Padma, M. V., Jain, S., Bhardwaj, M., Bhan, A., Kiran, U., Saxena, N., & Venugopal, P. (2000). Neurological evaluation and intelligence testing in the child with operated congenital heart disease. Annals of Thoracic Surgery, 70, 575–581.PubMedCrossRef

Silbert, A., Wolff, P. H., Mayer, A., Rosenthal, A., & Nada, A. S. (1969). Cyanotic heart disease and psychological development. Pediatrics, 43(2), 192–200.PubMed

Treasure, T., Naftel, D. C., Conger, K. A., Garcia, J. H., Kirklin, J. W., & Blackstone, E. H. (1983). The effect of hypothermic circulatory arrest time on cerebral function, morphology and biochemistry. Journal of Thoracic and Cardiovascular Surgery, 86, 761–770.PubMed

Uzark, K., Lincoln, A., Lamberti, J. J., Mainwaring, R. D., Spicer, R. L., & Moore, J. W. (1998). Neurodevelopmental outcomes in children with Fontan repair of functional single ventricle. Pediatrics, 101(4), 630–633.PubMedCrossRef

Van Hoecke, E., & Dhont, M. (2004). Aangeboren hartaandoening: verwerking door het kind en zijn ouders [Congenital heart disease: coping mechanisms of the child and its parents]. Tijdschrift voor Geneeskunde, 60(21),1548–1554.CrossRef

Visconti, K. J., Bichell, D. P., Jonas, R. A., Newburger, J. W., & Bellinger, D. C. (1999) Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation, 100(19), 145–150.

Wells, F. C., Coghill, S., Caplan, H. L., Lincoln, C., & Kirklin, J. W. (1983). Duration of cardiopulmonary arrest does influence the psychological development of children after cardiac operation in early life. Journal of Thoracic and Cardiovascular Surgery, 86, 823–831.PubMed

Wernovsky, G., Stiles, K. M., Gauvreau, K., Gentles, T. L., duPlessis, A. J., Bellinger, D. C., Walsh, A. Z., Burnett, J., Jonas, R. A., Mayer, J. E., & Newburger, J. W. (2000) Cognitive development after the Fontan operation. Circulation, 102(8), 883–889.PubMed

Wray, J., & Sensky, T. (1999). Controlled study of preschool development after surgery for congenital heart disease. Archives of Disease in Childhood, 80, 511–516.PubMed

Wray, J., & Sensky, T. (2001). Congenital heart disease and cardiac surgery in childhood: effects on cognitive function and academic ability. Heart, 85(6), 687–691.PubMedCrossRef

Wright, M., & Nolan, T. (1994). Impact of cyanotic heart disease on school performance. Archives of Disease in Childhood, 71, 64–70.PubMedCrossRef

Titel: Neurocognitive Consequences of Surgically Corrected Congenital Heart Defects: A Review
verfasst von: M. Miatton
D. De Wolf
K. François
E. Thiery
G. Vingerhoets
Publikationsdatum: 01.06.2006
Verlag: Springer US
Erschienen in: Neuropsychology Review / Ausgabe 2/2006
Print ISSN: 1040-7308
Elektronische ISSN: 1573-6660
DOI: https://doi.org/10.1007/s11065-006-9005-7

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen