Psychomotor and Cognitive Development and Quality of Life in Children and Adolescents with Congenital Heart Defect

Children with congenital heart disease (CHD) are at significant risk of psychomotor and cognitive developmental disorders, with negative effects on psychosocial and academic performance and quality of life. Innate characteristics such as genetic abnormalities, type and severity of CHD and socioeconomic factors are the most important risk factors. Prenatally, hypoperfusion or hypoxia can cause developmental and maturation disorders of the brain, thus promoting postpartum lesions of the more vulnerable brain substance and neurodevelopmental disorders. The high-risk group includes primarily infants requiring open heart surgery. Specific phenotypic characteristics of development emerge at different ages: in early childhood motor and linguistic articulation deficits; at school age impaired speech and language, attention, memory, visual-spatial, executive, and motor skills, often associated with academic deficits, and emotional or social issues; in adolescence executive, psychosocial and psychiatric disorders and impaired quality of life; in adulthood, neurocognitive, psychosocial and problems of self-management and professional perspective. Physical and social functioning, psychomotor development and mental health are key factors for quality of life. The German Society of Pediatric Cardiology demands detailed serial neuropsychological examinations at the age of 2 and 5 years, before puberty and before adulthood, for the high-risk group of children with CHD operated on in infant age in order to detect and to treat partial performance disorders at an early stage.