CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 3, May/June 2022 AFRICA 151 aimed at improving developmental performance, addressing musculoskeletal impairments, and limiting the extent of developmental delay post-operatively. Further research and analysis of clinical recruitment data in a larger sample are needed tobetter determine the feasibility, clinical value and best format of pre-operative neurodevelopmental assessment as part of routine cardiac neurodevelopmental care. Cardiac centres will need to track recruitment data to investigate strategies to overcome modifiable barriers to pre-operative neurodevelopmental assessment. Conclusions Pre-operative neurodevelopmental assessment was clinically valuable in identifying children at risk for and those presenting with developmental delays, facilitating early referral for formal developmental evaluation and rehabilitation therapies. Pre-operative neurodevelopmental assessment may be of high importance in South Africa where there are often extended waiting periods for cardiac surgery. Effective referral systems and recruitment strategies, and the fostering of collaborative relationships with clinical staff and parents are essential to the feasibility of pre-operative neurodevelopmental assessment. We acknowledge Prof Francis Smit and the Robert Frater Cardiovascular Research Institute for assistance with surgical data collection, and Dr Linda Potgieter for assistance and advice with the statistical analysis. We received funding assistance from the South African Society of Physiotherapy (SASP) Research Foundation, an individual research grant from the University of the Witwatersrand Faculty Research Committee, a sabbatical grant from the National Research Foundation (NRF) and a staff doctoral study support grant from the University of the Free State. References 1. Gaynor JW, Stopp C, Wypij D, Andropoulos DB, Atallah J, Atz AM, et al. Neurodevelopmental outcomes after cardiac surgery in infancy. Pediatrics 2015; 135(5): 816–825. 2. Marino BS, Lipkin PH, Newburger JW, Peacock G, Gerdes M, Gaynor 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(9): 1143–1172. 3. Snookes SH, Gunn JK, Eldridge BJ, Donath SM, Hunt RW, Galea MP, et al. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease. Pediatrics 2010; 125(4): e818–827. 4. Naguib A, Winch P, Tobias J, Yeates K, Miao Y, Galantowicz M, et al. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children. Saudi J Anaesth 2015; 9(1): 12. 5. Wernovsky G, Licht DJ. Neurodevelopmental outcomes in children with congenital heart disease – what can we impact? Pediatr Crit Care Med 2016; 18(8)(Suppl 1): S232–242. 6. Mussatto KA, Hoffmann RG, Hoffman GM, Tweddell JS, Bear L, Cao Y, et al. Risk and prevalence of developmental delay in young children with congenital heart disease. Pediatrics 2014; 133(3): e570–577. 7. Wilson WM, Smith-parrish M, Marino BS, Kovacs AH. Progress in pediatric cardiology neurodevelopmental and psychosocial outcomes across the congenital heart disease lifespan. Prog Pediatr Cardiol 2015; 39(2): 113–118. 8. Marino BS. New concepts in predicting, evaluating, and managing neurodevelopmental outcomes in children with congenital heart disease. Curr Opin Pediatr 2013; 25(5): 574–584. 9. Medoff-Cooper B, Irving SY, Hanlon AL, Golfenshtein N, Radcliffe J, Stallings VA, et al. The association among feeding mode, growth, and developmental outcomes in infants with complex congenital heart disease at 6 and 12 months of age. J Pediatr 2016; 169: 154–159. 10. Costello CL, Gellatly M, Daniel J, Sp B, Justo RN, Weir K. Growth restriction in infants and young children with congenital heart disease. Congenit Heart Dis 2015; 10: 447–456. 11. Lata K, Mishra D, Mehta V, Juneja M. Neurodevelopmental status of children aged 6–30 months with congenital heart disease. Indian Pediatr 2015; 52: 957–960. 12. Long SH, Eldridge BJ, Galea MP, Harris SR. Risk factors for gross motor dysfunction in infants with congenital heart disease. Infants Young Child 2011; 24(3): 246–258. 13. Robertson CMT, Sauve RS, Joffe AR, Alton GY, Moddemann DM, Blakley PM, et al. The registry and follow-up of complex pediatric therapies program of Western Canada: A mechanism for service, audit, and research after lifesaving therapies for young children. Cardiol Res Pract 2011; 2011: 965740 14. Majnemer A, Limperopoulos C, Shevell MI, Rohlicek C, Rosenblatt B, Tchervenkov C. A new look at outcomes of infants with congenital heart disease. Pediatr Neurol 2009; 40(3): 197–204. 15. Martinez-Biarge M, Jowett VC, Cowan FM, Wusthoff CJ. Seminars in fetal & neonatal medicine neurodevelopmental outcome in children with congenital heart disease. Semin Fetal Neonatal Med 2013; 18(5): 279–285. 16. Mebius MJ, Kooi EMW, Bilardo CM, Bos AF. Brain injury and neurodevelopmental outcome in congenital heart disease: a systematic review. Pediatrics 2017; 140(1): e20164055. 17. Marelli, A, Miller SP Marino,BS Jefferson, AS. Newburger J. Brain in congenital heart disease across the lifespan the cumulative burden of injury. Circulation 2016; 133: 1951–1962. 18. Khalil A, Suff N, Thilaganathan B, Hurrell A, Cooper D, Carvalho JS. Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis. Ultrasound Obs Gynecol 2014; 43: 14–24. 19. Homsy J, Zaidi S, Shen Y, Ware JS, Samocha KE, Karczewski KJ, et al. De novo mutations in congenital heart disease with neuridevelopmental and other congenital anomalies. Science 2015; 350(6265): 1262–1266. 20. Uzark K, Smith C, Donohue J, Yu S, Romano JC. Infant motor skills after a cardiac operation: the need for developmental monitoring and care. Ann Thorac Surg 2017; 104(2): 681–686. 21. Campbell M, Rabbidge B, Ziviani J, Sakzewski L. Clinical feasibility of preoperative neurodevelopmental assessment of infants undergoing open heart surgery. J Paediatr Child Health 2017; 53: 794–799. 22. Majnemer A, Limperopoulos C, Shevell MI, Rohlicek C, Rosenblatt B. A new look at outcomes of infants with congenital heart disease. Pediatr Neurol 2009; 40(3) :197–204. 23. Dittrich H, Grimmer I, Dittrich S, Lange PE. Neurodevelopment at 1 year of age in infants with congenital heart disease. Heart 2003; 89: 436–441. 24. Limperopoulos C, Majnemer A, Shevell MI, Rohlicek C, Rosenblatt B, Tchervenkov C, et al. Predictors of developmental disabilities after open heart surgery in young children with congenital heart defects. J Pediatr 2002; 141(1): 51–58. 25. Limperopoulos C, Majnemer A, Shevell MI, Rosenblatt B, Rohlicek C, Tchervenkov C. Neurodevelopmental status of newborns and infants with congenital heart defects before and after open heart surgery. J Pediatr 2000; 137(5): 638–645. 26. Limperopoulos C, Majnemer A, Shevell MI, Rosenblatt B, Rohlicek C, Tchervenkov C. Neurologic status of newborns with congenital heart defects before open heart surgery. Pediatrics 1999; 103(2): 402–408. 27. Campbell MJ, Ziviani JM, Stocker CF, Khan A, Sakzewski L. Neuromotor performance in infants before and after early open-heart surgery and risk factors for delayed development at 6 months of age. Cardiol Young 2019;
RkJQdWJsaXNoZXIy NDIzNzc=