Persistence of visuo-constructional and executive deficits in adolescents after open-heart surgery

Michael von Rhein; Julietta Kugler; Rabia Liamlahi; Walter Knirsch; Beatrice Latal; Liane Kaufmann

doi:10.1016/j.ridd.2014.10.027

Persistence of visuo-constructional and executive deficits in adolescents after open-heart surgery

Res Dev Disabil. 2015 Jan:36C:303-310. doi: 10.1016/j.ridd.2014.10.027. Epub 2014 Nov 4.

Authors

Michael von Rhein¹, Julietta Kugler², Rabia Liamlahi³, Walter Knirsch⁴, Beatrice Latal⁵, Liane Kaufmann⁶

Affiliations

¹ Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Pediatrics, Kantonsspital Winterthur, Brauerstr. 15, 8401 Winterthur, Switzerland. Electronic address: Michael.vonRhein@kispi.uzh.ch.
² Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
³ Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich/Children's Reseach Center, Switzerland.
⁴ Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich/Children's Reseach Center, Switzerland; Childrens Research Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
⁵ Child Development Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Childrens Research Center, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
⁶ Department of Psychiatry and Psychotherapy A, General Hospital, Milser Straße 10, 6060 Hall in Tyrol, Austria.

PMID: 25462490
DOI: 10.1016/j.ridd.2014.10.027

Abstract

Aim: This study assesses whether previously reported performance deficiencies in visuo-constructional and executive functions, using the Rey-Osterrieth Complex Figure Test (ROCFT) in pediatric patients with congenital heart disease (CHD), persist into adolescence.

Methods: 53 adolescent CHD patients (mean age 13.7) and 39 healthy controls (mean age 14.1) participated. ROCFT performance was measured by three different scoring methods, focusing either on quantitative (Meyers & Meyers, 1995), qualitative (Wallon & Mesmin, 2009), or both performance aspects (Bernstein & Waber, 1996). Potential confounders (i.e., intelligence and visuomotor integration) and surgery-related risk factors were included in the data analysis.

Results: Adolescents with CHD demonstrated immature copy and recall approaches on the ROCFT using the qualitative system by Wallon and Mesmin (p<.001). Memory performance was also predicted by Bernstein and Waber scores (p<.03), whereas group differences were not significant according to the other scoring methods. Intelligence and visuomotor skills, but not surgery-related risk factors, were positively correlated with ROCFT performance (each p<.02). Interpretation: Visuoconstructional and executive deficiencies could be found in adolescent patients with CHD. However, not all ROCFT scoring methods were equally apt to detect group differences: especially the qualitative scoring method developed by Wallon and Mesmin seems sufficiently sensitive to detect long-lasting visuo-constructional and executive deficiencies in CHD patients.

Keywords: Adolescent; Congenital heart defect; Open-heart surgery; ROCFT; Rey figure; Visuo-constructional.