Study in Erlangen researches heart surgery in young children
58,000 euros from the German Heart Research Foundation
The German Heart Research Foundation (Deutsche Stiftung für Herzforschung) is providing 58,000 euros of funding to Universitätsklinikum Erlangen for a study started in 2015 for research on adolescents who underwent heart surgery for a ventrical septal defect (VSD) at a very young age. This hole in the wall dividing the left and right ventricles of the heart is the most common congenital heart defect.
During their study in Erlangen, the doctors and psychologists involved hope to clarify to what extent the psychological development of a child who has received surgery for a VSD at an early age differs from that of a child who did not undergo surgery. In addition, the study will examine risk and protective factors for healthy development. The study is a cooperation project involving the Department of Child and Adolescent Mental Health and the Department of Paediatric Cardiac Surgery at Universitätsklinikum Erlangen.
The children involved in the study all successfully underwent heart surgery at Universitätsklinikum Erlangen and came to the Department of Child and Adolescent Mental Health to participate in the study at primary school age. Today, they are between 11 and 13 years old.
Upbringing, maternal wellbeing, surgery at an early age and an inconspicuous scar are beneficial
The results from the first survey in 2015 showed that the children who had undergone surgery were developing as well as the children in the healthy control group in terms of their cognitive and motor skills. Their well-being was also comparable to that of the children in the control group. The language skills of the young patients were also unaffected, provided that their mothers were very committed to their upbringing.
Providing support to mothers with their parenting skills thus seems especially promising for the healthy development of the children who received surgery. Any neurological abnormalities can evidently be compensated by the mother’s parenting behaviour. The children who had surgery only showed signs of behavioural problems when their mothers also developed strong feelings of anxiety. Less anxious mothers thus function as a ‘protective factor’ for the development of their children. Saliva samples enabled neurological stress markers to be included in the study. It became clear that the children’s stress systems remained unchanged, whereas their mothers often had higher levels of stress hormones than mothers of children with healthy hearts.
Information about the operation and the children’s stay in hospital were also compared with the data about their development. The researchers discovered that children with a longer scar from surgery had higher levels of anxiety. The longer the children stayed in hospital after their operation, the lower their IQ and psychomotility. The younger the children were when they had surgery, the better their wellbeing during primary school age. An operation at a young age and a ‘nice’ scar can thus be beneficial to a child’s development.
Second phase with children who had surgery and healthy children
The findings so far are promising, especially in terms of the search for risk and protective factors for children’s development. Studies that focus on children with congenital heart defects over a longer period of time are rare and no previous studies exist on a homogeneous group of children with congenital isolated VSD. ‘We are therefore all the more pleased that we are now able to continue our longitudinal study with the support of the German Heart Research Foundation,’ says PD Dr. Dr. Anna Eichler from the Department of Child and Adolescent Mental Health at Universitätsklinikum Erlangen, who is leading the study.
The 39 children who had received surgery and took part in the study in 2015 as well as the healthy children in the control group will now be invited back to Universitätsklinikum Erlangen so that data can be collected about them for a second time. ‘We now want to gain a deeper understanding of how stable or variable the impairments we found are and which role risk and protective factors play in psychological development,’ explains Eichler.
Amongst other factors, Dr. Eichler and her team will be including additional values of the stress hormone cortisol, which can be found in the hair of children and mothers. In addition, they will take a closer look at the length, width and appearance of the scar from heart surgery. ‘Ultimately, we want to provide paediatric heart surgeons and cardiologists with some information that is beneficial to children’s development’, says Anna Eichler.
Further information
PD Dr. Dr. Anna Eichler
Phone: + 49 9131 85 39123
anna.eichler@uk-erlangen.de