Recent studies highlight a high prevalence of difficulties at school and neurodevelopmental disorders in children with operated congenital heart disease, requiring development of systematic screening programs in cardiological centers.

A systematic screening program for neurodevelopmental disorders was recently developed within our institution for every patient who had cardiac surgery before the age of one year: the “neuro-heart program”.

This program involves an antenatal, pre-operative and post-operative global assessment allowing the child to be assigned to pathway A (screening for neurodevelopmental disorders by parental questionnaires at key ages through a smartphone application), pathway B (reassessment necessary at 3 month) or pathway C (specific follow-up at CAMPS with support from physiotherapist, speech therapist, psychomotor therapists, etc…).

Between October 2020 and march 2025, 213 patients operated under extracorporeal circulation before the age of one year were included. 100% of patients were pointed towards a care pathway: 94 patients were referred to pathway A, 58 to pathway B and 60 to pathway C. 75% of parents answered the 6 months ASQ questionnaire, with 62% of children having at least one area < -2SD (including 79% in gross motor) ( Fig. 1 ). 85% of parents answered the 12 months ASQ questionnaire, with 67% of children having at least one area < -2SD (including 92% in gross motor). 65% of parents answered the 24 months ASQ questionnaire.

The use of a smartphone application facilitates the screening of neurodevelopmental disorders with good parental compliance. Difficulties before the age of 2 are mainly in gross motor, even among children with no apparent difficulties, suggesting that physical therapy should be prescribed in early childhood. After cardiac surgery with sternotomy, the transition to the ventral position is always a source of stress for parents, whereas it should probably be encouraged to improve the overall motor skills of these infants and their neurodevelopmental trajectory.