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Outcome of Pregnancy Following Intervention for Coarctation of the Aorta

children with hypoplastic left heart syndrome. These two reviewed studies have shown that children following surgery have full-scale IQs of 80 or more, indicating at least average to low-average intelligence. However, it is clear that many of the children ranging in age from 4 to 9 years of age following early surgery for hypoplastic left heart syndrome will have neurodevelop-mental issues clinically. It is of concern that 59% of the patients in the study of Mahle et al met the criteria for attention deficit hyperactivity disorder, 14% were microcephalic with the possibility of mental retardation, and 17% had cerebral palsy. It also seems clear from these two studies that long cardiopulmonary bypass times are detrimental to the later neurodevelopmental outcome in these patients. It seems critical that careful short-term and long-term developmental evaluations need to be done on these patients to learn more about their neurodevelopmental outcome. Such data may serve as an impetus to improve the immediate postoperative care in the first few days of life after surgery. We need to do whatever we can to have short cardiopulmonary bypass times and operate on these patients, if possible, before they have suffered significant liver and kidney damage. DSM