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Erschienen in: Pediatric Cardiology 5/2007

01.10.2007

Long-Term Behavior and Quality of Life After Corrective Cardiac Surgery in Infancy for Tetralogy of Fallot or Ventricular Septal Defect

verfasst von: H. H. Hövels-Gürich, K. Konrad, D. Skorzenski, R. Minkenberg, B. Herpertz-Dahlmann, B. J. Messmer, M.-C. Seghaye

Erschienen in: Pediatric Cardiology | Ausgabe 5/2007

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Abstract

The objective of this study was to evaluate behavior and quality of life in children after corrective cardiac surgery in infancy. Twenty cyanotic (tetralogy of Fallot) and 20 acyanotic children (ventricular septal defect), operated at a mean age of 0.7 years with deep hypothermic circulatory arrest (DHCA) and low-flow cardiopulmonary bypass (CPB), were assessed at a mean age of 7.4 years by the Child Behavior Checklist (CBCL) and the German KINDL. Test results were related to perioperative and neurodevelopmental outcome. Compared to healthy children and not significantly different between the groups, internalizing and externalizing problems were elevated, school performance and total competence were reduced, and self- and parent-reported quality of life was not reduced. Parent-reported problems and reduced physical status were correlated with longer durations of DHCA and CPB. Internalizing and externalizing problems, reduced school competence, and reduced self-esteem were associated with reduced endurance capacity. Externalizing problems were related to reduced gross motor function. Poor school competence was related to reduced intelligence and academic achievement. Children with preoperative hypoxemia in infancy due to cyanotic cardiac defects are not at significantly higher risk for behavioral problems and reduced quality of life than those with acyanotic heart defects. The risk of long-term psychosocial maladjustment after corrective surgery in infancy is increased compared to that for normal children and related to the presence of neurodevelopmental dysfunction.
Literatur
1.
Zurück zum Zitat Achenbach TM (1991) Integrative Guide for the 1991 CBCL/4-18, YSR, and TRF Profiles. University of Vermont, Burlington Achenbach TM (1991) Integrative Guide for the 1991 CBCL/4-18, YSR, and TRF Profiles. University of Vermont, Burlington
2.
Zurück zum Zitat Bellinger DC, Jonas RA, Rappaport LA, et al. (1995) Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. N Engl J Med 332:549–555CrossRefPubMed Bellinger DC, Jonas RA, Rappaport LA, et al. (1995) Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. N Engl J Med 332:549–555CrossRefPubMed
3.
Zurück zum Zitat Bellinger DC, Wypij D, Kuban KC, et al. (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 100:526–532PubMed Bellinger DC, Wypij D, Kuban KC, et al. (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 100:526–532PubMed
4.
Zurück zum Zitat Cumming GR, Everatt D, Hastman L (1978) Bruce treadmill test in children: normal values in a clinic population. Am J Cardiol 41:69–75CrossRefPubMed Cumming GR, Everatt D, Hastman L (1978) Bruce treadmill test in children: normal values in a clinic population. Am J Cardiol 41:69–75CrossRefPubMed
5.
Zurück zum Zitat Daliento L, Mapell E, Russo G, et al. (2005) Health-related quality of life in adults with repaired tetralogy of Fallot: psychological and cognitive outcomes. Heart 91:213–218CrossRefPubMed Daliento L, Mapell E, Russo G, et al. (2005) Health-related quality of life in adults with repaired tetralogy of Fallot: psychological and cognitive outcomes. Heart 91:213–218CrossRefPubMed
6.
Zurück zum Zitat De Maso DR, Beardslee WR, Silbert AR, Fyler DC (1990) Psychological functioning in children with cyanotic heart defects. J Dev Behav Pediatr 11:289–294 De Maso DR, Beardslee WR, Silbert AR, Fyler DC (1990) Psychological functioning in children with cyanotic heart defects. J Dev Behav Pediatr 11:289–294
7.
Zurück zum Zitat De Maso DR, Campis LK, Wypij D, et al. (1991) The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Pediatr Psychol 16:137–149CrossRef De Maso DR, Campis LK, Wypij D, et al. (1991) The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Pediatr Psychol 16:137–149CrossRef
8.
Zurück zum Zitat Du Plessis AJ (1999) Mechanisms of brain injury during infant cardiac surgery. Semin Pediatr Neurol 6:32–47CrossRefPubMed Du Plessis AJ (1999) Mechanisms of brain injury during infant cardiac surgery. Semin Pediatr Neurol 6:32–47CrossRefPubMed
9.
Zurück zum Zitat Forbess JM, Visconti KJ, Bellinger DC, Howe RJ, Jonas RA (2002) Neurodevelopmental outcomes after biventricular repair of congenital heart defects. J Thorac Cardiovasc Surg 123:631–639CrossRefPubMed Forbess JM, Visconti KJ, Bellinger DC, Howe RJ, Jonas RA (2002) Neurodevelopmental outcomes after biventricular repair of congenital heart defects. J Thorac Cardiovasc Surg 123:631–639CrossRefPubMed
10.
Zurück zum Zitat Hövels-Gürich HH, Konrad K, Wiesner M, et al. (2002) Long term behavioural outcome after neonatal arterial switch operation for transposition of the great arteries. Arch Dis Child 87:506–510CrossRefPubMed Hövels-Gürich HH, Konrad K, Wiesner M, et al. (2002) Long term behavioural outcome after neonatal arterial switch operation for transposition of the great arteries. Arch Dis Child 87:506–510CrossRefPubMed
11.
Zurück zum Zitat Hövels-Gürich HH, Konrad K, Skorzenski D, et al. (2006) Long-term neurodevelopmental outcome and exercise capacity after corrective surgery for tetralogy of Fallot or ventricular septal defect. Ann Thorac Surg 81:958–967CrossRefPubMed Hövels-Gürich HH, Konrad K, Skorzenski D, et al. (2006) Long-term neurodevelopmental outcome and exercise capacity after corrective surgery for tetralogy of Fallot or ventricular septal defect. Ann Thorac Surg 81:958–967CrossRefPubMed
12.
Zurück zum Zitat Hövels-Gürich HH, Konrad K, Skorzenski D, et al. (2006) Attentional dysfunction of children after corrective surgery in infancy. Ann Thorac Surg, 81:1425–30CrossRef Hövels-Gürich HH, Konrad K, Skorzenski D, et al. (2006) Attentional dysfunction of children after corrective surgery in infancy. Ann Thorac Surg, 81:1425–30CrossRef
13.
Zurück zum Zitat Hövels-Gürich HH, Seghaye MC, Däbritz S, Messmer BJ, von Bernuth G (1997) Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 114:578–585CrossRefPubMed Hövels-Gürich HH, Seghaye MC, Däbritz S, Messmer BJ, von Bernuth G (1997) Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 114:578–585CrossRefPubMed
14.
Zurück zum Zitat Hövels-Gürich HH, Seghaye MC, Schnitker, et al. (2002) Long term neurodevelopmental outcome in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 124:448–458CrossRefPubMed Hövels-Gürich HH, Seghaye MC, Schnitker, et al. (2002) Long term neurodevelopmental outcome in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 124:448–458CrossRefPubMed
15.
Zurück zum Zitat Kaufman AS, Kaufman NL (1994) Kaufman Assessment Battery for Children (K-ABC) [German version: Melchers U, Preuß U], 2nd ed. Swets & Zeitlinger, Lisse, The Netherlands Kaufman AS, Kaufman NL (1994) Kaufman Assessment Battery for Children (K-ABC) [German version: Melchers U, Preuß U], 2nd ed. Swets & Zeitlinger, Lisse, The Netherlands
16.
Zurück zum Zitat Kiphard EJ, Schilling F (1974) Körper-Koordinationstest für Kinder. Beltz-Verlag, Weinheim-Basel, Germany Kiphard EJ, Schilling F (1974) Körper-Koordinationstest für Kinder. Beltz-Verlag, Weinheim-Basel, Germany
17.
Zurück zum Zitat McGrath E, Wypij D, Rappaport LA, Newburger JW, Bellinger DC (2004) Prediction of IQ and achievement at age 8 years from neurodevelopmental status at age 1 year in children with D-transposition of the great arteries. Pediatrics 114:572–576CrossRef McGrath E, Wypij D, Rappaport LA, Newburger JW, Bellinger DC (2004) Prediction of IQ and achievement at age 8 years from neurodevelopmental status at age 1 year in children with D-transposition of the great arteries. Pediatrics 114:572–576CrossRef
18.
Zurück zum Zitat Moore H, Kleining G (1968) Das soziale Selbstbild der Gesellschaftsschichten in Deutschland. Kölner ZSoziologie Sozialpsychologie 20:86–119 Moore H, Kleining G (1968) Das soziale Selbstbild der Gesellschaftsschichten in Deutschland. Kölner ZSoziologie Sozialpsychologie 20:86–119
19.
Zurück zum Zitat Müller-Godeffroy E, Lehmann H, Küster RM, Thyen U (2005) Quality of life and psychosocial adaptation in children and adolescents with juvenile idiopathic arthritis and reactive arthritis. Z Rheumatol 64:177–187CrossRefPubMed Müller-Godeffroy E, Lehmann H, Küster RM, Thyen U (2005) Quality of life and psychosocial adaptation in children and adolescents with juvenile idiopathic arthritis and reactive arthritis. Z Rheumatol 64:177–187CrossRefPubMed
20.
Zurück zum Zitat Norozi K, Gravenhorst V, Hobbiebrunken E, Wessel A (2005) Normality of cardiopulmonary capacity in children operated on to correct congenital heart defects. Arch Pediatr Adolesc Med 159:1063–1068CrossRefPubMed Norozi K, Gravenhorst V, Hobbiebrunken E, Wessel A (2005) Normality of cardiopulmonary capacity in children operated on to correct congenital heart defects. Arch Pediatr Adolesc Med 159:1063–1068CrossRefPubMed
21.
Zurück zum Zitat Oates RK, Simpson JM, Turnbull JA, Cartmill TB (1995) The relationship between intelligence and duration of circulatory arrest with deep hypothermia. J Thorac Cardiovasc Surg 110:786–792CrossRefPubMed Oates RK, Simpson JM, Turnbull JA, Cartmill TB (1995) The relationship between intelligence and duration of circulatory arrest with deep hypothermia. J Thorac Cardiovasc Surg 110:786–792CrossRefPubMed
22.
Zurück zum Zitat Oates RK, Turnbull JA, Simpson JM, Cartmill TB (1994) Parent and teacher perceptions of child behaviour following cardiac surgery. Acta Paediatr 83:1303–1307PubMed Oates RK, Turnbull JA, Simpson JM, Cartmill TB (1994) Parent and teacher perceptions of child behaviour following cardiac surgery. Acta Paediatr 83:1303–1307PubMed
23.
Zurück zum Zitat Ravens-Sieberer U, Bullinger M (1998) Assessing health-related quality of life in chronically ill children with the German KINDL: first psychometric and content analytical results. Qual Life Res 7:399–407CrossRefPubMed Ravens-Sieberer U, Bullinger M (1998) Assessing health-related quality of life in chronically ill children with the German KINDL: first psychometric and content analytical results. Qual Life Res 7:399–407CrossRefPubMed
24.
25.
Zurück zum Zitat Ravens-Sieberer U, Görtler E, Bullinger M (2000) Subjective health and health behavior of children and adolescents—a survey of Hamburg students within the scope of school medical examination. Das Gesundheitswesen 62:148–155CrossRefPubMed Ravens-Sieberer U, Görtler E, Bullinger M (2000) Subjective health and health behavior of children and adolescents—a survey of Hamburg students within the scope of school medical examination. Das Gesundheitswesen 62:148–155CrossRefPubMed
26.
Zurück zum Zitat Schneider K, Walter R, Remschmidt H (1991) Untersuchungen zur Validität einer deutschen Version der Child-Behavior Checklist (CBCL). Z Klin Psychiatrie 20:52–64 Schneider K, Walter R, Remschmidt H (1991) Untersuchungen zur Validität einer deutschen Version der Child-Behavior Checklist (CBCL). Z Klin Psychiatrie 20:52–64
27.
Zurück zum Zitat Schultz AH, Wernovsky G (2005) Late outcomes in patients with surgically treated congenital heart disease. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, pp 145–156 Schultz AH, Wernovsky G (2005) Late outcomes in patients with surgically treated congenital heart disease. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, pp 145–156
28.
Zurück zum Zitat Shillingford AJ, Wernovsky G (2004) Academic performance and behavioral difficulties after neonatal and infant heart surgery. Pediatr Clin North Am 51:1625–1639CrossRefPubMed Shillingford AJ, Wernovsky G (2004) Academic performance and behavioral difficulties after neonatal and infant heart surgery. Pediatr Clin North Am 51:1625–1639CrossRefPubMed
29.
Zurück zum Zitat Ternestedt BM, Wall K, Oddsson H, et al. (2001) Quality of life 20 and 30 years after surgery in patients operated for tetralogy of Fallot and for atrial septal defect. Pediatr Cardiol 22:128–132CrossRefPubMed Ternestedt BM, Wall K, Oddsson H, et al. (2001) Quality of life 20 and 30 years after surgery in patients operated for tetralogy of Fallot and for atrial septal defect. Pediatr Cardiol 22:128–132CrossRefPubMed
30.
Zurück zum Zitat Utens EM, Verhulst FC, Duivenvoorden HJ, et al. (1998) Prediction of behavioural and emotional problems in children and adolescents with operated congenital heart disease. Eur Heart J 19:801–807CrossRefPubMed Utens EM, Verhulst FC, Duivenvoorden HJ, et al. (1998) Prediction of behavioural and emotional problems in children and adolescents with operated congenital heart disease. Eur Heart J 19:801–807CrossRefPubMed
31.
Zurück zum Zitat Utens EM, Versluis-Den Bieman HJ, Witsenburg M, et al. (2002) Does age at time of elective surgery or catheter intervention in children influence the longitudinal development on psychological distress and styles of coping of parents? Cardiol Young 12:524–530CrossRefPubMed Utens EM, Versluis-Den Bieman HJ, Witsenburg M, et al. (2002) Does age at time of elective surgery or catheter intervention in children influence the longitudinal development on psychological distress and styles of coping of parents? Cardiol Young 12:524–530CrossRefPubMed
32.
Zurück zum Zitat Van Rijen EHM, Utens EMWJ, Roos-Hesseklink JW, et al. (2004) Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 25:1605–1613CrossRefPubMed Van Rijen EHM, Utens EMWJ, Roos-Hesseklink JW, et al. (2004) Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 25:1605–1613CrossRefPubMed
33.
Zurück zum Zitat Walker WT, Temple IK, Gnanapragasam JP, Goddard JR, Brown EM (2002) Quality of life after repair of tetralogy of Fallot. Cardiol Young 12:549–553CrossRefPubMed Walker WT, Temple IK, Gnanapragasam JP, Goddard JR, Brown EM (2002) Quality of life after repair of tetralogy of Fallot. Cardiol Young 12:549–553CrossRefPubMed
34.
Zurück zum Zitat Wray J, Sensky T (2001) Congenital heart disease and cardiac surgery in childhood: effects on cognitive function and academic ability. Heart 85:687–691CrossRefPubMed Wray J, Sensky T (2001) Congenital heart disease and cardiac surgery in childhood: effects on cognitive function and academic ability. Heart 85:687–691CrossRefPubMed
35.
Zurück zum Zitat Wray J, Sensky T (2004) Psychological functioning in parents of children undergoing elective cardiac surgery. Cardiol Young 14:131–139CrossRefPubMed Wray J, Sensky T (2004) Psychological functioning in parents of children undergoing elective cardiac surgery. Cardiol Young 14:131–139CrossRefPubMed
36.
Zurück zum Zitat Wypij D, Newburger FW, Rappaport LA, et al. (2003) The effect of duration of deep hypothermic circulatory arrest in infant heart surgery on late neurodevelopment: the Boston Circulatory Arrest Trial. J Thorac Cardiovasc Surg 126:1397–1403CrossRefPubMed Wypij D, Newburger FW, Rappaport LA, et al. (2003) The effect of duration of deep hypothermic circulatory arrest in infant heart surgery on late neurodevelopment: the Boston Circulatory Arrest Trial. J Thorac Cardiovasc Surg 126:1397–1403CrossRefPubMed
Metadaten
Titel
Long-Term Behavior and Quality of Life After Corrective Cardiac Surgery in Infancy for Tetralogy of Fallot or Ventricular Septal Defect
verfasst von
H. H. Hövels-Gürich
K. Konrad
D. Skorzenski
R. Minkenberg
B. Herpertz-Dahlmann
B. J. Messmer
M.-C. Seghaye
Publikationsdatum
01.10.2007
Erschienen in
Pediatric Cardiology / Ausgabe 5/2007
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-006-0123-z

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