Early Neurodevelopmental Outcomes After Corrective Cardiac Surgery In Infants

Objective: To assess neurodevelopmental status in Indian infants undergoing corrective surgery for congenital heart disease (CHD) and to analyze factors associated with neurodevelopmental delay. Design : Cross-sectional study. Setting: Tertiary-care pediatric cardiology facility. Participants: Consecutive infants undergoing corrective surgery for CHD (January 2013-December 2014). Palliative procedures, and patients with known genetic syndromes were excluded. Main outcome measures: Neurodevelopmental evaluation 3 months, and one year after surgery using Developmental Assessment Scales for Indian Infants (DASH); scores were categorized as delayed if <= 70. Results: Of the 162 children enrolled, delayed PDI and MDI scores were observed in 33.5% and 19.6% of patients at 3 months, respectively; this reduced to 14.5 % on 1-year follow-up. On multivariate analysis, delayed PDI outcome at one year was predicted by early term birth and one-year postoperative head circumference Z-score <-2. Delayed MDI was associated with higher mean perfusion pressure on cardiopulmonary bypass. Cardiac diagnosis and pen-operative factors did not impact neurodevelopmental outcomes. Conclusions: Neurodevelopmental status is delayed in 14.5% of infants one year after corrective infant heart surgery.