1. Development of Weight and Height Age z-Score after Total Cavopulmonary Connection.
- Author
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Bilic C, Staehler H, Niedermaier C, Schaeffer T, Cuman M, Heinisch PP, Burri M, Piber N, Hager A, Ewert P, Hörer J, and Ono M
- Subjects
- Humans, Female, Male, Child, Preschool, Treatment Outcome, Infant, Time Factors, Risk Factors, Age Factors, Retrospective Studies, Fontan Procedure adverse effects, Norwood Procedures adverse effects, Heart Defects, Congenital surgery, Heart Defects, Congenital physiopathology, Child Development, Hypoplastic Left Heart Syndrome surgery, Hypoplastic Left Heart Syndrome physiopathology, Weight Gain, Palliative Care, Infant, Newborn, Body Height
- Abstract
Objective: We aimed to analyze somatic growth of patients after total cavopulmonary connection (TCPC) as well as to identify factors influencing postoperative catch-up growth., Methods: A total of 309 patients undergoing TCPC at 4 years old or less between 1994 and 2021 were included. Weight for age z-score (WAZ) and height for age-z-score (HAZ) at TCPC and at postoperative time between 1 and 3 years were calculated. Factors influencing somatic growth were analyzed., Results: Most frequent diagnosis and initial palliation were hypoplastic left heart syndrome (HLHS) (34%) and the Norwood procedure (51%), respectively. Median age and weight at TCPC were 2.0 (IQR: 1.7-2.5) years and 11.3 (10.5-12.7) kg, respectively. Median 519 days after TCPC, a significant increase in WAZ (-0.4 to -0.2, p < 0.001) was observed, but not in HAZ (-0.6 to -0.6, p = 0.38). Older age at TCPC ( p < 0.001, odds ratio [OR]: 2.6) and HLHS ( p = 0.007, OR: 2.2) were risks for low WAZ after TCPC. Older age at TCPC ( p = 0.009, OR: 1.9) and previous Norwood procedure ( p = 0.021, OR: 2.0) were risks for low HAZ after TCPC. Previous bidirectional cavopulmonary shunt (BCPS) was a protective factor for both WAZ ( p = 0.012, OR: 0.06) and HAZ ( p = 0.028, OR: 0.30) at TCPC., Conclusion: In patients undergoing TCPC at the age of 4 years or less, a significant catch-up growth was observed in WAZ after TCPC, but not in HAZ. Previous BCPS resulted to be a protective factor for a better somatic development at TCPC. HLHSs undergoing Norwood were considered as risks for somatic development after TCPC., Competing Interests: None declared., (Thieme. All rights reserved.)
- Published
- 2024
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