Assessment & Research

Neurodevelopmental outcome after surgery for acyanotic congenital heart disease.

Sarrechia et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

Kids who had simple heart-hole surgery can still show quiet cognitive hits—screen visuospatial, language, attention, and social skills early.

✓ Read this if BCBAs doing assessments or school consults for late-elementary clients with any congenital heart surgery history.
✗ Skip if Clinicians who only serve adults or clients with no medical history.

01Research in Context

01

What this study did

Iemke et al. (2015) looked at kids who had surgery for acyanotic congenital heart disease. These are simple holes in the heart that were fixed early in life.

The team gave a full neuropsych battery to the children and to matched controls. They tested visuospatial skills, language, attention, and social perception.

02

What they found

The heart-surgery group scored lower in every area. The dips were small, but they showed up on every test.

Parents and teachers often miss these slips because the kids look healthy. The study says screen early, before schoolwork gets hard.

03

How this fits with other research

Rakonjac et al. (2016) saw the same pattern in children with 22q11.2 deletion who also had heart surgery. Both papers blame the surgery history, not just the gene change.

Chen et al. (2019) tracked preschoolers with ASD and found immature brain-stem responses that forecast later language trouble. Iemke’s heart-surgery kids had language hits too, linking surgery stress to later auditory issues.

Bathelt et al. (2019) showed that severe congenital visual impairment lowers quality of life. Iemke’s group shows that even invisible heart repairs can quietly chip away at cognition, so both studies warn against assuming a child is fine because the condition is fixed.

04

Why it matters

If you work with school-age clients who had atrial or ventricular septal defect repair, add quick visuospatial and language probes to your intake. Catching these soft deficits now lets you add targeted teaching strategies before reading or math stalls.

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Add a quick block-design or spatial memory task to your assessment battery for any client with an aCHD repair note in the file.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
46
Population
other
Finding
negative
Magnitude
small

03Original abstract

BACKGROUND: Inconsistent results on neuropsychological outcome in patients treated for acyanotic congenital heart disease (aCHD) questioned the clinical relevance of possible neurobehavioral sequelae in this group. This study was designed to objectify the neuropsychological profile and evaluate associations with medical data. METHODS: Patients with a corrected atrial or ventricular septal defect, ASD-II or VSD, (n=46; mean age 9 years, 2 months) and a matched control group were submitted to an intelligence test (Wechsler Intelligence Scale for Children, third edition, Dutch version) and evaluated with a neuropsychological test battery (Developmental Neuropsychological Assessment, second edition, Dutch version). Hospitalization variables were retrieved to evaluate associations with cognitive outcome. Parents completed a behavioral checklist (Achenbach Child Behavior Checklist for Children aged 6-18). RESULTS: ASD-II patients showed lower scores in domains of visuospatial processing, language, attention, and social perception. VSD patients displayed subtle problems in attention and visuospatial information processing. Only few perioperative medical factors, but also socioeconomic variables were associated with cognitive outcomes. Parents of ASD-II patients reported more school problems when compared to controls. CONCLUSIONS: After treatment for aCHD, subtle cognitive difficulties can present in domains of visuospatial information processing, language, attention, and social perception. These shortcomings might hamper school performances, as is suggested by lower school competence ratings. Ongoing follow-up and cognitive screening is warranted to promote developmental progress, in which both parents and clinicians share responsibility.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.07.004