Neurodevelopmental Outcomes In Children With Single Ventricle Physiology After Fontan Procedure: A Systematic Review

Abstract

Background: Congenital heart disease with single ventricle that requires Fontan palliation poses a great neurodevelopmental issue that affects the quality of life in the long term.

Objective: The proposed systematic review is an attempt to synthesize the recent findings related to neurodevelopmental outcomes after Fontan procedure in children.

Methods: Thorough search of various databases that pinpoint peer-reviewed open-access articles that explored cognitive function, executive function, mental health, and other risk determinants.

Results: Post-Fontan children have recurrent neurodevelopmental malfunctioning such as processing speed deficiency, executive malfunction, and psychiatric morbidity. The intelligence quotient scores are at a low level that is far below population norms but quite normal in general.

Conclusions: Fontan survivors are associated with severe neurodevelopment problems requiring serious multidisciplinary follow-up in childhood and adolescence. There should also be early detection and specific intervention measures to make sure that the neurodevelopmental outcomes are maximized in the long term. The effects of patient-specific factors and perioperative morbidities are more likely to predict the outcomes than the surgical technique.