We read with great interest the article by Miller et al1 about early neurological outcome after open heart surgery. The authors state that neurological symptoms and complications are not uncommon after surgery for congenital heart disease (and even before): 15% of the infants had seizures, 11% had choreic movements, and 34% were hypotonic at discharge. At discharge, there were no differences between patients subjected to hypothermic circulatory arrest or low-flow cardiopulmonary bypass. However, we think that these figures may be somewhat misleading for the reader, ie, the practicing pediatrician.
First, the series described by Miller et al does not reflect the normal spectrum of congenital heart disease in infancy; reported prevalence data of congenital cardiopathies presenting in the neonatal age are quite different: 6% to 18% for ventricular septal defects, 7% to 12% for tetralogy of Fallot, 8% to 15% for dextrotransposition of the great arteries (d-TGA), and 9%