Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-15T03:24:53.641Z Has data issue: false hasContentIssue false

Impact of congenital heart surgery on quality of life in children and adolescents with surgically corrected Ventricular Septal Defect, Tetralogy of Fallot, and Transposition of the Great Arteries

Published online by Cambridge University Press:  09 July 2019

Line M. Holst*
Affiliation:
Department of Cardiothoracic Anaesthesia, Intensive Care Unit, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
Jonas B. Kronborg
Affiliation:
Department of Cardiothoracic Anaesthesia, Intensive Care Unit, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
Lars Idorn
Affiliation:
Department of Paediatric Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
Jesper V. Bjerre
Affiliation:
Department of Paediatric Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
Niels Vejlstrup
Affiliation:
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
Klaus Juul
Affiliation:
Department of Paediatric Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
Hanne B. Ravn
Affiliation:
Department of Cardiothoracic Anaesthesia, Intensive Care Unit, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
*
Author for correspondence: L. M. Holst, MD, Department of Cardiothoracic Anaesthesiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK- 2100 Copenhagen, Denmark. Tel: +4535454141; Fax: +4535452785; E-mail: [email protected]

Abstract

Objective:

To describe the impact of CHD surgery in early childhood on quality of life in children aged 10–16 years with surgically corrected Ventricular Septal Defect, Transposition of the Great Arteries, and Tetralogy of Fallot.

Method:

A cross-sectional survey study of quality of life survey on 161 children and adolescents aged 10–16 years with surgically corrected Ventricular Septal Defect, Transposition of the Great Arteries, and Tetralogy of Fallot. The international Paediatric Quality of Life 4.0 quality of life questionnaires were applied and collected for assessment from patients and parents. The endpoints were total, physical, emotional, social, and school quality of life scores.

Results:

The quality of life total and school scores was significantly lower in children with CHD than their healthy peers. There was no significant difference in quality of life between the three CHD groups. All three CHD groups had a significantly lower total (7.7–13.2%, p<0.001) and school scores (21.1–31.6%, p<0.001) than the control group. The tetralogy of Fallot group was the only group that had significantly lower scores in the physical subscale (p<0.001) than the controls.

Conclusion:

Children and adolescents with surgically corrected CHD show losses in quality of life in total and school scores compared to healthy controls. The tetralogy of Fallot group was the only CHD group that had significantly lower physical score than the controls.

Type
Original Article
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Marino, BS, Lipkin, PH, Newburger, JW, et al. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 2012; 126: 11431172.CrossRefGoogle ScholarPubMed
International Cardiac Collaborative on Neurodevelopment Investigators. Impact of operative and postoperative factors on neurodevelopmental outcomes after cardiac operations. Ann Thorac Surg 2016; 102: 843849.CrossRefGoogle Scholar
Marino, BS, Cassedy, A, Drotar, D, Wray, J. The impact of neurodevelopmental and psychosocial outcomes on health-related quality of life in survivors of congenital heart disease. J Pediatr 2016; 174: 1122.e2.CrossRefGoogle ScholarPubMed
Idorn, L, Jensen, AS, Juul, K, et al. Quality of life and cognitive function in Fontan patients, a population-based study. Int J Cardiol 2013; 168: 32303235.CrossRefGoogle ScholarPubMed
Bratt, EL, Luyckx, K, Goossens, E, Budts, W, Moons, P. Patient-reported health in young people with congenital heart disease transitioning to adulthood. J Adolesc Health 2015; 57: 658665.CrossRefGoogle ScholarPubMed
Apers, S, Moons, P, Goossens, E, et al. Sense of coherence and perceived physical health explain the better quality of life in adolescents with congenital heart disease. Eur J Cardiovasc Nurs 2013; 12: 475483.CrossRefGoogle ScholarPubMed
Mellion, K, Uzark, K, Cassedy, A, et al. Health-related quality of life outcomes in children and adolescents with congenital heart disease. J Pediatr 2014; 164: 781788.e1.CrossRefGoogle ScholarPubMed
Heusch, A, Kahl, HJ, Hensel, KO, Calaminus, G. Health-related quality of life in paediatric patients with congenital heart defects: association with the type of heart defect and the surgical technique. Qual Life Res 2017; 26: 31113117.CrossRefGoogle ScholarPubMed
Marino, BS, Shera, D, Wernovsky, G, et al. The development of the pediatric cardiac quality of life inventory: a quality of life measure for children and adolescents with heart disease. Qual Life Res 2008; 17: 613626.CrossRefGoogle ScholarPubMed
Bambul Heck, P, Pabst von Ohain, J, Kaemmerer, H, Ewert, P, Hager, A. Quality of life after surgical treatment of coarctation in long-term follow-up (CoAFU): predictive value of clinical variables. Int J Cardiol 2018; 250: 116119.CrossRefGoogle ScholarPubMed
Muller, J, Berner, A, Ewert, P, Hager, A. Reduced health-related quality of life in older patients with congenital heart disease: a cross sectional study in 2360 patients. Int J Cardiol 2014; 175: 358362.CrossRefGoogle ScholarPubMed
Uzark, K, Jones, K, Slusher, J, Limbers, CA, Burwinkle, TM, Varni, JW. Quality of life in children with heart disease as perceived by children and parents. Pediatrics 2008; 121: e1060e1067.CrossRefGoogle ScholarPubMed
Varni, JW, Seid, M, Kurtin, PS. PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001; 39: 800812.CrossRefGoogle ScholarPubMed
Bellinger, DC, Jonas, RA, Rappaport, LA, et al. Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. N Engl J Med 1995; 332: 549555.CrossRefGoogle ScholarPubMed
Hovels-Gurich, HH, Konrad, K, Skorzenski, D, Herpertz-Dahlmann, B, Messmer, BJ, Seghaye, MC. Attentional dysfunction in children after corrective cardiac surgery in infancy. Ann Thorac Surg 2007; 83: 14251430.CrossRefGoogle ScholarPubMed
Bellinger, DC, Bernstein, JH, Kirkwood, MW, Rappaport, LA, Newburger, J. Visual-spatial skills in children after open-heart surgery. J Dev Behav Pediatr 2003; 24: 169179.CrossRefGoogle ScholarPubMed
Bellinger, DC, Newburger, JW, Wypij, D, Kuban, KC, duPlesssis, AJ, Rappaport, LA. Behaviour at eight years in children with surgically corrected transposition: the Boston circulatory arrest trial. Cardiol Young 2009; 19: 8697.CrossRefGoogle ScholarPubMed
Ballweg, JA, Wernovsky, G, Gaynor, JW. Neurodevelopmental outcomes following congenital heart surgery. Pediatr Cardiol 2007; 28: 126133.CrossRefGoogle ScholarPubMed
Mahle, WT. Neurologic and cognitive outcomes in children with congenital heart disease. Curr Opin Pediatr 2001; 13: 482486.CrossRefGoogle ScholarPubMed
Hovels-Gurich, HH, Bauer, SB, Schnitker, R, et al. Long-term outcome of speech and language in children after corrective surgery for cyanotic or acyanotic cardiac defects in infancy. Eur J Paediatr Neurol 2008; 12: 378386.CrossRefGoogle ScholarPubMed
Hovels-Gurich, HH, Konrad, K, Skorzenski, D, et al. Long-term neurodevelopmental outcome and exercise capacity after corrective surgery for tetralogy of Fallot or ventricular septal defect in infancy. Ann Thorac Surg 2006; 81: 958966.CrossRefGoogle ScholarPubMed
Wright, M, Nolan, T. Impact of cyanotic heart disease on school performance. Arch Dis Child 1994; 71: 6470.CrossRefGoogle ScholarPubMed
Simons, JS, Glidden, R, Sheslow, D, Pizarro, C. Intermediate neurodevelopmental outcome after repair of ventricular septal defect. Ann Thorac Surg 2010; 90: 15861591.CrossRefGoogle ScholarPubMed
Eichler, A, Kohler-Jonas, N, Stonawski, V, et al. Child neurodevelopment and mental health after surgical ventricular septal defect repair: risk and protective factors. Dev Med Child Neurol 2019; 61: 152160.CrossRefGoogle ScholarPubMed
Carvalho, JS, Shinebourne, EA, Busst, C, Rigby, ML, Redington, AN. Exercise capacity after complete repair of tetralogy of Fallot: deleterious effects of residual pulmonary regurgitation. Br Heart J 1992; 67: 470473.CrossRefGoogle ScholarPubMed
Moe, TG, Bardo, DME. Long-term outcomes of the arterial switch operation for d-transposition of the great arteries. Prog Cardiovasc Dis 2018; 61: 360364.CrossRefGoogle ScholarPubMed
Samos, F, Fuenmayor, G, Hossri, C, et al. Exercise capacity long-term after arterial switch operation for transposition of the great arteries. Congenit Heart Dis 2016; 11: 155159.CrossRefGoogle ScholarPubMed
Heiberg, J, Laustsen, S, Petersen, AK, Hjortdal, VE. Reduced long-term exercise capacity in young adults operated for ventricular septal defect. Cardiol Young 2015; 25: 281287.CrossRefGoogle ScholarPubMed
Gratz, A, Hess, J, Hager, A. Self-estimated physical functioning poorly predicts actual exercise capacity in adolescents and adults with congenital heart disease. Eur Heart J 2009; 30: 497504.CrossRefGoogle ScholarPubMed
O’Connor, AM, Wray, J, Tomlinson, RS, et al. Impact of surgical complexity on health-related quality of life in congenital heart disease surgical survivors. J Am Heart Assoc 2016; 5: e001234.Google ScholarPubMed
Kruger, J, Dunning, D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol 1999; 77: 11211134.CrossRefGoogle ScholarPubMed
Agergaard, P, Hebert, A, Bjerre, J, Sorensen, KM, Olesen, C, Ostergaard, JR. Children diagnosed with congenital cardiac malformations at the national university departments of pediatric cardiology: positive predictive values of data in the Danish National Patient Registry. Clin Epidemiol 2011; 3: 6166.CrossRefGoogle ScholarPubMed
Matthiesen, NB, Henriksen, TB, Gaynor, JW, et al. Congenital heart defects and indices of fetal cerebral growth in a nationwide cohort of 924 422 liveborn infants. Circulation 2016; 133: 566575.Google Scholar