Neurodevelopment and behavior after transcatheter versus surgical closure of secundum type atrial septal defect

Sarrechia, Iemke; De Wolf, Daniël; Miatton, Marijke; François, Katrien; Gewillig, Marc; Meyns, Bart; Vingerhoets, Guy

doi:10.1016/J.JPEDS.2014.08.039

Title

Neurodevelopment and behavior after transcatheter versus surgical closure of secundum type atrial septal defect

Author

Sarrechia, Iemke

De Wolf, Daniël

Miatton, Marijke

François, Katrien

Gewillig, Marc

Meyns, Bart

Vingerhoets, Guy

Abstract

Objective To assess the neuropsychological and behavioral profiles of school-aged children treated for atrial septal defect, secundum type (ASD-II) with open-heart surgery or catheterization. Study design Patients (n = 48; mean age, 9 years, 3 months) and a matched healthy group (mean age, 9 years, 2 months) were evaluated with a shortened intelligence scale (Wechsler Intelligence Scale for Children, third edition, Dutch version) and a developmental neuropsychological test battery (Developmental Neuropsychological Assessment, second edition, Dutch version). Parents completed behavioral checklists (Achenbach Child Behavior Checklist for Children aged 6-18). Hospitalization variables were retrieved from medical files for studying associations with long-term neurodevelopment. Results Compared with the healthy matched controls, patients treated for ASD-II had significantly lower scores on subtasks underlying such Developmental Neuropsychological Assessment, second edition, Dutch version domains as Attention and Executive Functioning, Language, Working Memory, Sensorimotor Functioning, Social Cognition, and Visuospatial Information Processing. Only subtle differences, mainly in Visuospatial Information Processing, were found between the surgical repair and transcatheter repair groups. Socioeconomic status, longer hospital stay, and larger defect size were associated with neurocognitive outcome measures. Parents of patients reported more thought problems, posttraumatic stress problems, and lower school performance compared with parents of healthy peers. Conclusion After treatment for ASD-II, children display a range of neuropsychologic difficulties that may increase their risk for learning problems and academic underachievement. Differences related to treatment were not found. Our results suggest that neurodevelopmental and behavioral follow-up at school age is warranted in this group.

Language

English

Source (journal)

The journal of pediatrics. - St.Louis, Mo.

The Journal of pediatrics

Publication

St.Louis, Mo. : 2015

ISSN

0022-3476

DOI

10.1016/J.JPEDS.2014.08.039

Volume/pages