As results for reparative and palliative congenital heart surgery improve, the importance of long-term outcome has shifted from survival to neurodevelopmental outcome and associated quality of life. Neurodevelopmental assessments and quality of life measurements provide important anticipatory guidance for patients, families, teachers, and therapists. The landmark Boston Circulatory Arrest study has followed longitudinally neurodevelopmental outcome in the largest cohort of infants undergoing congenital heart surgery. These patients underwent repair of transposition of the great arteries (+/— VSD closure) between 1988 and 1992. The most recent evaluation of the patients at 16 years of age found academic achievement, memory, executive function, and visual-spatial skills were all lower than population means.
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