Abstract The aim of the present study was to explore developmental outcome, psychosocial
adjustment and self-regulation of children who underwent corrective surgery for congenital
heart disease (CHD) in early infancy and a possible association with type and procedural
characteristics of the intervention. Two groups of children with CHD aged 2 to 6 years operated
in infancy for ventricular septal defect (n519) or as neonates for transposition of the great
arteries (n525) and a reference group (n535) underwent developmental and psychological
testing. Vagal tone as an index for emotional self-regulation capabilities was measured during
baseline and challenge conditions. The study shows that children who underwent surgery for
CHD in early infancy were at a disadvantage for cognitive, emotional, and motor development
compared to the reference group at preschool age. Behavioural outcome and psychosocial
adjustment were generally positive in our sample and we conclude that surgical procedures leave
no discernable trace in the vagal regulation system. Developmental and behavioural outcome
were moderately related to oesophageal temperature and total support time during the surgery,
but not uniformly across different areas of development. It seems likely that familial and
environmental factors have a mediating influence.