Developmental progress after cardiac surgery in infancy using hypothermia and circulatory arrest.

Abstract

Seventy-two of 76 long-term survivors who had surgical repair of congenital heart lesions at 11 days to 26 months of age using profound hypothermia and circulatory arrest underwent psychometric testing (Stanford-Binet) late postoperatively. The mean IQ of the 72 patients was 92.9 +r16.5 (SD). Stanford-Binet scores bore no relationship to the duration of circulatory arrest or other aspects of surgical technique. Scores were significantly lower in those who had a low birth weight for gestational age, important neurologic problems preoperatively or were in the lower socioeconomic classes. An "ideal" control group of 69 children randomly selected from patients satisfying certain criteria based on birth and neonatal characteristics had a mean IQ of 106.2 +r11.6. Twenty-five patients who had surgical treatment of cogenital heart disease met the criteria for the control group except for their heart lesions. Their mean IQ was 101.4 +r15.0(NS). We could not demonstrate any significant deleterious effect that could be attributed to the surgical methods. Rather, the postoperative IQ scores reflected characteristics related to individual patients.