Clinical and neurological features of the development of children with critical and non-critical cyanotic congenital heart defects after surgical treatment
DOI:
https://doi.org/10.15574/SP.2024.140.39Keywords:
young children, psychomotor development, progressive muscle weakness, acute cerebrovascular accident, aortic defect, treatment tacticsAbstract
Aim - to investigate neurological disorders in children with critical and non-critical cyanotic congenital heart defects (CCHD) after surgical treatment.
Materials and methods. 62 patients from 0 to 3 years old were examined with CCHD. All children were divided into 2 groups: the Group 1 (31 children) with critical CCHD and the Group 2 (31 children) with non-critical CCHD. The Control group consisted of 35 healthy patients. The main methods of assessing neurological status: Hammersmith neurological examination of infants, Munich functional diagnosis of child development, assessment of general movements of infants according to the Prechtl method. Statistical evaluation of the data was carried out using the licensed statistical package “Stata 12.1”.
Results. In the Group 1, neurodevelopmental disorders were diagnosed in 29% of all 62 children with CCHD: delayed stato-motor development - 15%, delayed speech development - 7% and others. In the Group 2, neurodevelopmental disorders were diagnosed in 24% of all 62 children with CCHD: delayed stato-motor development - 16%, delayed speech development - 3% and others. Groups of children with impaired and normal neurodevelopment were homogeneous in terms of gestational age and body weight. In the case of neurodevelopmental disorders, a lower Apgar score and an increase in the duration of artificial blood circulation were noted.
Conclusions. The use of the Hammersmith neurological examination of infants, the Munich functional diagnosis of child development, the assessment of the general movements of newborns and infants according to the Prechtl method is one of the most valid methods. Neurological disorders were characterized by a rather wide spectrum, the main part of which was a delay in stato-motor development. In children with critical CCHD, a more severe condition was noted at birth, which is probably one of the reasons for the formation of neuropsychological disorders. Children with CCHD need to follow the neurodevelopmental assessment algorithm, taking into account the terms of surgical treatment for the timely development of an individual rehabilitation program.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of parents was obtained for conducting research.
The authors declare no conflict of interest.
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