Assessment of children`s psychomotor development in the remote period after aortic arch reconstruction with antegrade cerebral perfusion

Abstract

Objective. To evaluate the psychomotor development of children after aortic arch reconstruction in the conditions of selective antegrade cerebral perfusion. Materials and methods. The results of surgical treatment and psychomotor development of 48 children aged 1 to 3 years, who underwent reconstruction of the aortic arch in terms of artificial circulation and selective antegrade cerebral perfusion at the age of 1 year at the Amosov National Institute of Cardiovascular Surgery and the Scientific and Practical Medical Center of Pediatric Cardiology and Cardiac Surgery in the period from 2014 to 2019 were analyzed. To study the cognitive sphere and motor development of children we used the 2nd edition of the method "Bayley Scales of Infant Development - II". In analyzing the results in children with psychomotor developmental delay, the values of the mental index and the index of psychomotor development were taken into account. Results. 2 (3.7%) patients died after surgery. Postoperative mortality was connected with neurological complications and technique of cerebral perfusion. In the remote period no patient died. According to neurosonography in the postoperative period, no pathological structural changes in the brain were detected. In 16 (33.3%) children at the age of 1 year there was a slight delay in mental and / or psychomotor development. Evaluation of the results of the survey in the dynamics showed that at the age of 3 years, 9 (18.7%) children had a slight development delay. The average values of the mental index in 1 year were 81.2 ± 8.6, and in 3 years - 96.4 ± 12.7 (p <0.05), and the index of psychomotor development - respectively 83.3 ± 11.4 and 94.5 ± 10.2 (p <0.05). The difference between the indicators of mental and psychomotor indices in children with congenital heart disease at 1 year and 3 years is statistically significant. Conclusions. A delay in psychomotor development at the age of 1 year was revealed in 33.3% of children after the aortic arch reconstruction in the conditions of selective antegrade cerebral perfusion. This indicates the need for further research and monitoring. A statistically significant difference between the indicators of mental and psychomotor development of children aged 1 and 3 years after aortic arch reconstruction indicates a positive dynamics and recovery of psychomotor development with age in most of children.

Keywords

• antegrade cerebral perfusion; psychomotor development; hypoplasia of the aortic arch.