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Dev Med Child Neurol. 2013 Dec;55(12):1143-9. doi: 10.1111/dmcn.12242. Epub 2013 Aug 13.

Neurodevelopmental outcome, psychological adjustment, and quality of life in adolescents with congenital heart disease.

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Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland.



The aim of this study was to examine neurodevelopment, psychological adjustment, and health-related quality of life (HRQoL) in adolescents after bypass surgery for congenital heart disease (CHD) during early childhood.


Fifty-nine adolescents (34 females, 25 males) with CHD were examined at a median age of 13 years 8 months (range 11 y 5 mo-16 y 11 mo). Outcome was assessed with the Wechsler Intelligence Scale for Children, (fourth edition); the Beery Test of Visual-Motor Integration; the Rey-Osterrieth Complex Figure Test; the Zurich Neuromotor Assessment; the Strengths and Difficulties Questionnaire; and the KIDSCREEN questionnaires. Results were compared with those of 40 age- and sex-matched healthy comparison individuals.


Outcome with regard to full-scale IQ, perceptual reasoning, and the working memory scale was poorer in patients with CHD than in the comparison group (all p ≤ 0.001). Visual perception, visuomotor integration (p ≤ 0.001), and executive functions (Rey figure copy: p=0.05) were also affected. Patients with CHD also had lower scores on all motor domains (p < 0.02) except static balance. Psychological adjustment was affected only in the 'peer relationship' domain (p=0.05). Quality of life was similar to that of typically developing peers.


Adolescents with CHD may manifest persistent cognitive and motor impairments, while psychological adjustment and self-reported HRQoL are mostly typical. Thus, long-term neurodevelopmental evaluations are necessary to provide early educational and therapeutic support.

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