Neurodevelopmental Outcomes Following Aortic Surgery in the Paediatric Population

Abstract

Abstract Introduction: Complex aortic surgeries during infancy may affect the neurodevelopmental of children. The study aimed to outline the neurological outcomes and probable risk factors in patients who had undergone aortic surgeries during infancy. Method: A systematic search of English language articles from Academic Search Complete, Cochrane Database, MEDLINE, ScienceDirect, and Scopus was performed. Studies using tools to assess neurodevelopmental outcomes in the pediatric population who underwent aortic surgery in infancy were reviewed. Studies with non-aortic surgeries and prior neurological comorbidities were excluded. Results: Eight cohort studies and two randomized control trials involving 2776 patients were included. Wechsler Intelligent Scale (WIS) (67%) was the most commonly used tool to measure IQ followed by the Bayley Infant Development scale (BIDS). Two studies reported a lower psychomotor developmental index score in 25% of their cohort. Approximately 32% demonstrated a poor Full Scale Intelligent Quotient of less than 70. Motor dyspraxia was the most commonly reported neurological dysfunction (50%). Low weight at surgery and longer surgical duration affect the neurocognitive process. Conclusions: Complex aortic surgeries and their perioperative course leave significant neurocognitive complications which may be progressive into adulthood. This study suggests that infants undergoing complex aortic surgery would benefit from long-term neurocognitive surveillance to identify emerging complications.