Behavioural and emotional outcomes in school-aged children after surgery or transcatheter closure treatment for ventricular septal defect

Objection: We aimed to assess and compare the behavioural and emotional outcomes of school-aged children after surgery or transcatheter closure for ventricular septal defect and investigate the risk factors for developing abnormal behavioural problems with the condition. Methods: In this study, we included 29 children, including 20 boys, with ventricular septal defect who underwent surgery and 35 children, including 21 boys, who underwent transcatheter closure (6-13 years old) and their age-and sex-matched best friends (n = 56) and their parents. The Child Behavior Checklist was used to obtain standardised parents' reports of behavioural and emotional problems in children. The 28-item version of the General Health Questionnaire was used to assess parents' psychological distress. Pearson correlation and logistic regression were used to analyse risk factors for developing behaviour problems. Results: Behavioural problems were greater for boys and girls undergoing surgery or transcatheter closure than controls. The behavioural problems were mainly depression, somatic complaints, and social withdrawal for boys and thought problems, depression, somatic complaints, and social withdrawal for girls. Depression and somatic complaints were greater for boys undergoing surgery than for boys undergoing transcatheter closure. Behavioural problems did not differ between treatment groups for girls. Risk factors for developing behavioural problems were age at the time of ventricular septal defect repair (p = 0.03; odds ratio = 2.35), skin scar (p = 0.04; odds ratio = 3.12), post-operative atrioventricular block (p = 0.03; odds ratio = 2.81), and maternal anxiety(p < 0.01; odds ratio = 4.5). Conclusion: School-aged children who underwent repair of ventricular septal defect regardless of the type of treatment (surgery or transcatheter closure) exhibit internalising behavioural problems. Risk factors for developing problems are young age, scarring, post-operative atrioventricular block, and maternal anxiety. In particular, maternal anxiety is the most important risk factor.