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Original Articles: Pediatric Cardiac

Intermediate Neurodevelopmental Outcome After Repair of Ventricular Septal Defect

^a Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, Delaware
^b Division of Behavioral Health, A. I. duPont Hospital for Children, Wilmington, Delaware

Accepted for publication June 14, 2010.

^_* Address correspondence to Dr Simons, Nemours Cardiac Center, A. I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE 19803 (Email: jsimons{at}nemours.org).

Background: Children with congenital heart disease are at risk for impaired neurodevelopmental outcome. Despite the high prevalence of ventricular septal defects relative to other cardiac defects, few studies have specifically examined this population. The purpose of this study was to provide data on the intermediate neurodevelopmental outcome for children after repair of a ventricular septal defect.

Methods: Neurodevelopmental outcome was assessed for 31 children using standardized tests of IQ, memory, visual-motor ability, and academic achievement. Standardized parent and teacher reports of behavioral and psychosocial functioning were also examined. Patients were grouped into younger (less than 6 years old; n = 18) and older (6 years and older; n = 13) cohorts.

Results: Full-scale IQ scores were within the normal range. Although most other domains of neurodevelopmental and behavioral functioning were comparable to normative data, patient functioning was lower than population norms in the areas of performance IQ for the younger cohort (90.6 ± 16.1; p = 0.023), visual memory for the older cohort (84.5 ± 15.3; p = 0.003), and visual-motor ability (87.9 ± 14.2; p < 0.001) and adaptive behavior (94.3 ± 15.3; p = 0.050) for the entire cohort.

Conclusions: After repair of ventricular septal defects, children function within the normal range in most areas. Three of the four domains in which lower functioning was observed tap into visual cognitive abilities rather than verbal abilities. Lower mean scores in these areas were, however, generally within one standard deviation of the population mean, suggesting mild weaknesses rather than significant impairments.

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