Although it is known that pediatric cardiac surgery holds risks for later development,
few studies investigated the long-term development in children with tetralogy of Fallot.
The purpose of this study was to define their intellectual capacities, neuropsychological
profile, and behavioral functioning 6 to 12 years postoperatively.
Patients (n = 18; age, 8 years, 3 months ± 1 year, 6 months) were examined with a
short-form intelligence scale (Wechsler Intelligence Scale for Children, 3rd edition,
Dutch version) and a neuropsychological assessment battery (NEPSY). Their parents
completed a behavioral questionnaire. The patient group was compared with an acyanotic
congenital heart disease group and a healthy control group.
No significant differences between the patient group and the acyanotic group emerged.
Compared with the healthy control group, children with tetralogy of Fallot showed
significantly lower scores on the estimated Full Scale IQ (P < .05) and on the NEPSY domains Language (P < .01) and Sensorimotor Functioning (P < .01). Also, the subtests Tower (P < .05), Memory for Names (P < .05), Narrative Memory (P < .05), and Design Copy (P < .05) elicited group differences. Parental reports revealed significantly higher
scores on attention problems (P < .05) and the total problem scale (P < .05), as well as significantly lower school performances than those of healthy
peers (P < .01).
In children with tetralogy of Fallot, we identified a lower estimated full-scale intelligence
than in healthy peers and a neuropsychological profile characterized by primarily
mild motor deficits and difficulties with language tasks. Parents of the children
with tetralogy of Fallot indicated attention problems and rated the child’s school
competencies to be lower than in healthy control subjects.