Developmental outcome and psychosocial adjustment in children after surgery for congenital heart disease during infancy

Abstract

The aim of the present study was to explore developmental outcome, psychosocial adjustment and self‐regulation of children who underwent corrective surgery for congenital heart disease (CHD) in early infancy and a possible association with type and procedural characteristics of the intervention. Two groups of children with CHD aged 2 to 6 years operated in infancy for ventricular septal defect (n = 19) or as neonates for transposition of the great arteries (n = 25) and a reference group (n = 35) underwent developmental and psychological testing. Vagal tone as an index for emotional self‐regulation capabilities was measured during baseline and challenge conditions. The study shows that children who underwent surgery for CHD in early infancy were at a disadvantage for cognitive, emotional, and motor development compared to the reference group at preschool age. Behavioural outcome and psychosocial adjustment were generally positive in our sample and we conclude that surgical procedures leave no discernable trace in the vagal regulation system. Developmental and behavioural outcome were moderately related to oesophageal temperature and total support time during the surgery, but not uniformly across different areas of development. It seems likely that familial and environmental factors have a mediating influence.