Cognitive speech disorders in children with congenital heart defects aged 5–7 years

Abstract

   Purpose. To found out expressive speech disorders as a sign of neurocognitive development delay in children with congenital heart defects before and after surgery.   Material and methods: 216 children with congenital heart defects were divided into groups according to the presence (group 1, n = 71) and absence (group 2, n = 145) of family history confounding factors, and studied before surgery and in 1 and 2 years after definitive repair under cardiopulmonary bypass. The anamnesis, clinical and hemodynamic aspects were studied before and after surgery, mental status and expressive speech diagnostics were also performed.   Results. The predictors of neurocognitive impairment in children with congenital heart defects before surgery were identified: the level of heart failure, comorbidity, burdened family history. 76.3 % of children had «average» level of neurocognitive development (more in group 2) in a year after surgical correction, while 23.6 % had «low» and «very low» level (more in group 1); there were general expressive speech disorders in 68 % children in group 1 and in 55 % in group 2 among all children. «High» level of neurocognitive development was recorded in 2 years (13.8 % among all children), while the number of children with general expressive speech disorders was approximately the same despite of positive dynamic of clinical and hemodynamic aspects.   Conclusion. There are «low» levels of neurocognitive development and expressive speech disorders in children with congenital heart defects in long term postoperative period despite of clinical and hemodynamic normalization. It can predict significant risks and poor quality of life in the absence of timely correction.