Surgery versus intervention in congenital heart disease as a risk factor for executive dysfunction: a case control study

Abstract

Background Improving surgical and interventional modalities for treating congenital heart disease increased these children's living expectancy, a leading cause of cognitive and behavioral problems. This study compared executive functions among surgically, interventionally treated congenital heart disease, and aged match control. Methods This was a retrospective cross-sectional study. We enrolled thirty children treated with surgery, 30 interventionally treated patients and 30 healthy controls. We compared these participants in the executive functions domains by Stroop test, trail making test, cancellation test, visual and auditory memory span test, and behavioral problems using the parent form strength and difficulty questionnaire. Executive performance in memory span and sustained attention was lower in the surgical group than in the intervention group (P˂0.05). Results Both groups of patients had lower flexibility, memory recall, simple and complex working memory, visual attention, and simple and complex selective attention performance (P < 0.05). The effect of behavioral problems on daily life was higher in surgical patients than in the intervention group (P˂0.0001). Both groups of patients had higher emotional problems, conduct problems, and communication problems than the normal group (P˂0.0001). Conclusion Interventionaly treated patients had better performance in comparison to surgically-treated patients. Regardless of the severity of the disease or treatment, patients with congenital heart malformations had poor performance compared to normal subjects and suffered from behavioral disorders affecting their daily lives. It is essential to include diagnostic and therapeutic interventions in treating these patients' executive function and behavioral problems.