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European Heart Journal Advance Access published online on September 27, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn432
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Open-heart surgery at school age does not affect neurocognitive functioning

Rachel van der Rijken1,*, Gerdine Hulstijn-Dirkmaat1, Floris Kraaimaat1, Lida Nabuurs-Kohrman1, Aagje Nijveld2, Ben Maassen1 and Otto Daniëls3

1 Department of Medical Psychology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
2 Department of Cardiothoracic Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
3 Children's Heart Centre, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands

Received 30 November 2007; revised 3 July 2008; accepted 12 September 2008.

* Corresponding author. Tel: +31 24 3613947, Fax: +31 24 3613425, Email: r.vanderrijken{at}cukz.umcn.nl

Aims: Although neurocognitive problems after open-heart surgery for congenital heart disease are frequent, due to a shortage of prospective studies assessing neurocognitive functioning both before and after the procedure, the exact nature of the deficits usually remains unknown. The present study aims at assessing the neurocognitive effects of, in particular, cardiopulmonary bypass at school age. In addition, surgery-related risk factors for reduced neurocognitive outcome are explored.

Methods and results: Participants were aged between 6 and 16 years. Forty-three children indicated for open-heart surgery and a comparison group of 19 children scheduled for interventional cardiac catheterization completed a neurocognitive assessment battery before and 1 year after their procedures. Forty healthy matched controls did so at a 1 year interval. The baseline-to-follow-up outcomes were similar in all three groups. The observed improvements most likely resulted from increased age and the repeated neurocognitive assessment. No risk factors for postsurgical neurocognitive deficits were identified.

Conclusion: The present study demonstrates that at school age cardiac surgery using full-flow cardiopulmonary bypass does not affect neurocognitive functioning.

Key Words: Congenital heart disease • Open-heart surgery • Cardiopulmonary bypass • Neurocognitive functioning • School age • Risk factors


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