Fontan Procedure's Effect on Intelligence Assessed

Despite corrective surgery known as the Fontan procedure, children who need that procedure have ongoing deficits.

The Fontan procedure, a surgery to partially correct circulatory deficits in children born with hypoplastic left heart syndrome (HLHS) is a relatively new procedure. The congenital heart problem can lead to cyanosis, acidosis, and other events that can have effects on the brain. Researchers set out to see if those effects are less serious after corrective surgery.

The Fontan procedure re-routes blood through the right side of the heart to bypass blockages on the left side. When successful, it results in more oxygenated blood reaching the brain.

In a study to be presented April 2 at the American College of Cardiology Scientific Session in Chicago, IL, Billie-Jean Martin and colleagues from the University of Alberta, Edmonton Canada, looked at children who got Fontan surgery to assess whether they had neurocognitive problems.

The patients were operated on from 1996 to 2013. They looked at Wechsler intelligence scores in these children and controls. The first assessments were done at kindergarten age.

The team found that though the Fontan group’s scores were within normal range, they were lower than controls.

“Children who have undergone Fontan palliation have intelligence scores below population mean, placing them at risk for lower school achievement,” they concluded.

“There is a trend for the full-scale [IQ] score for those with HLHS to be lower than those without HLHS,” and that means these children could benefit from early intervention education programs, as well as long-term follow-up of educational and work performance, they concluded.