Cognitive function in congenital heart disease after cardiac surgery with extracorporeal circulation.

BACKGROUND Congenital heart disease (CHD) may cause deleterious effects on cognitive function in children. This study aimed to evaluate the changes of the cognitive and academic functioning in children aged less than 4 years with serious CHD following cardiac surgery with extracorporeal circulation (ECC). METHODS A total of 100 children, aged 0-4 years with cyanotic (35) and acyanotic (65) heart diseases who had undergone cardiac surgery with ECC, were subjected to neuropsychological and behavioral evaluation using the Gesell Developmental Schedule (GDS) before operation and at 1 week, and 1, 3 and 6 months after operation. RESULTS The GDS scores in the first postoperative week were significantly lower than those before operation, but the scores increased gradually (P<0.01). ECC affected the GDS scores after operation, with the cyanotic children being more significantly affected than the acyanotic children. The GDS scores were negatively correlated with the age at each time point. The GDS scores were significantly lower in the cyanotic children than in the acyanotic children at 1 and 3 months postoperatively (P<0.01), but there was no significant difference at 6 months (P<0.05). CONCLUSIONS After cardiac surgery with ECC, the younger the children who have cardiac surgery, the more significantly the GDS score increases. The ECC mainly affects the cognitive ability and academic performance in cyanotic children in one month postoperatively.