Neurodevelopment and psychosocial adjustment in children with early surgical ventricular septal defect repair: exploring the influence of surgery-related variables across childhood and adolescence.

BACKGROUND: This study investigates the effects of surgery-related variables on child neurodevelopment, internalizing symptoms, health-related quality of life (HRQoL), and maternal psychopathology following early child surgical Ventricular Septal Defect (VSD) repair. METHODS: 24 children (54.2% females) who underwent VSD surgery (age at surgery: Range 1.38 to 33.18 months) and their mothers were examined from child primary school-age (T1; M = 7.3 years, SD = 0.99) to early adolescence (T2; M = 12.4 years, SD = 0.93). Surgery-related variables (age at surgery, duration of surgery, cardiopulmonary bypass time, post-surgical hospital stay) were retrospectively reviewed, surgical scar characteristics were measured at T2. Child neurodevelopment, mother-reported internalizing symptoms and HRQoL were assessed at both time points, with adolescents also rating their internalizing symptoms and HRQoL at T2. Data were analyzed using repeated measures analyses of covariance (T1-T2). RESULTS: An older age at surgery was linked to lower child long-term HRQoL. Time-based surgery-related variables (duration of surgery, cardiopulmonary bypass time) were associated with higher HRQoL at T1, while a longer duration of surgery affected maternal psychopathology at T2. A prolonged post-surgical hospital stay was negatively related to child neurodevelopment, and negatively predicted internalizing symptoms and child-rated HRQoL at T2. Longer surgical scars were correlated with higher child anxiety at T1 and lower long-term HRQoL, while wider scars were associated with increased depressive symptoms and lower HRQoL over time, and higher maternal psychopathology at T1. CONCLUSIONS: In sum, surgery-related variables primarily influenced child long-term psychosocial adjustment, with less impact on neurodevelopment. Postoperative variables have demonstrated greater relevance compared to time-based surgery-related variables. Effective management during all surgical phases is therefore crucial for both somatic and psychosocial recovery.