Early Neurodevelopmental Outcomes After Corrective Cardiac Surgery In Infants

Objective: To assess neurodevelopmental status in Indian infantsundergoing 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 surgeryfor CHD (January 2013 –December 2014). Palliative procedures,and patients with known genetic syndromes were excluded.Main outcome measures: Neurodevelopmental evaluation 3months, and one year after surgery using DevelopmentalAssessment Scales for Indian Infants (DASII); scores werecategorized as delayed if ?70.Results: Of the 162 children enrolled, delayed PDI and MDIscores were observed in 33.5% and 19.6% of patients at 3months, respectively; this reduced to 14.5 % on 1-year follow-up.On multivariate analysis, delayed PDI outcome at one year waspredicted by early term birth and one-year postoperative headcircumference Z-score <–2. Delayed MDI was associated withhigher mean perfusion pressure on cardiopulmonary bypass.Cardiac diagnosis and peri-operative factors did not impactneurodevelopmental outcomes.Conclusions: Neurodevelopmental status is delayed in 14.5% ofinfants one year after corrective infant heart surgery