Abstract 17582: Encouraging Neurodevelopmental Outcomes in Children with Hypoplastic Left Heart Syndrome at Five Years of Age
Introduction: Patients with hypoplastic left heart syndrome (HLHS) have neurodevelopmental (ND) problems, some of which can be linked to perioperative risk factors. We hypothesized that children with HLHS would perform worse than test norms on ND outcome measures at early school age.
Methods: English-speaking patients with HLHS at 4-6 years of age were eligible to participate. 44/72 (61%) patients agreed to participate, 37 completed ND testing before close of the study. Three patients were excluded from analyses due to late stroke. Mean age at testing was 5 years (range 4 to 6 years). ND testing included intelligence, visual motor integration, motor skills, memory, and language skills. Parents and teachers completed measures of behavior and attention problems. Patient scores and parent/teacher ratings were converted to z scores and compared to test norms. Scores are displayed in Figure 1 as multidimensional deviations from the test norm at z=0. Higher scores on child measures represent better outcomes, whereas higher scores on parent/teacher rating scales indicate more problems.
Results: The average ND performance of the tested cohort fell within one standard deviation from test norms for all measures. Children with HLHS performed significantly lower than test norms on measures of visual-motor integration, fine motor skills, memory, and word structure (z=-.42 to -.54). On parent and teacher completed measures, children with HLHS scored higher than test norms on attention problems (z=.40 to .62).
Conclusion: ND outcome for preschool aged survivors of staged palliation for HLHS in the modern era is encouraging. Although overall ND performance was normal, the cohort showed relative weakness in attention and executive functioning. Ongoing developmental monitoring of these children is recommended to guide interventions that may improve individual outcomes, and to assess the impact of changes in clinical management strategies on functional outcomes.
- © 2011 by American Heart Association, Inc.