BAYLEY-III score to evaluate neurodevelopment after pediatric cardiac surgery

Abstract

Introduction: Neurodevelopment in children with congenital heart disease is a major concern. Bayley scales are a standardized instru ment used to assess this. Objectives: Our goal was to evaluate Bayley-III scores among infants undergoing cardiac surgery in our institution. Methods: We evaluated the neurodevelopment of infants under 4years who underwent cardiac surgery with extracorporeal circula- tion during 2016-2019 at our institution. We excluded preterm ba- bies, children with chromosomal abnormalities, hearing loss, cerebral palsy, or ECMO before surgery. Results: Sixty infants with a mean age of 2.95 ± 3.28 months at the time of the surgery were assessed at 26.46 ± 8.47 months after sur- gery. Main diagnostic groups were septal defects(n = 18), right sided heart diseases(n = 12), anomalies of thoracic arteries and/or veins(n = 10), transposition of the great arteries(n = 9), left sided heart diseases(n = 5), single ventricle(n = 3) and other(n = 3). Complete repair was achieved in 93% of cases, 4 children were palliated. Mean Bayley-III scores were highest in left sided heart diseases (98.73 ± 4.02) and transposition of great arteries (93.93 ± 12.61). Scores were significantly lower in children with single ventricle physiology (78.89 ± 15.49; p = 0.04) and palliative procedures (73.41 ± 16.73; p = 0.02) when compared to the rest of the cohort. We did not find statistically significant association between Bayley-III scores and pump times beyond 90 min, low weight at surgery (2.5 Kg), surgery during neonatal period (30 days), selective cerebral perfusion, intu- bation time nor PICU/NICU length of stay. Conclusions: Single ventricle physiology and palliative procedures have a detrimental outcome on neurodevelopment in children. Although other variables studied did not yield statistically significant results, it is mandatory to continue following the neurodevelopment of these infants in order to apply appropriate therapies and edu- cation.