Document Detail


Somatic growth in children with single ventricle physiology impact of physiologic state.
MedLine Citation:
PMID:  17980255     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to define somatic growth patterns for patients with single ventricle (SV) physiology and associated factors. BACKGROUND: Infants with SV physiology might have somatic growth retardation associated with volume overload and hypoxemia, which might improve after surgical palliation. METHODS: We reviewed 126 patients (35% male) who underwent the Fontan procedure from 1994 to 2004. Demographic data, hemodynamic variables, and surgical procedures were recorded. Serial weights and heights were converted to z-scores. Linear regression analysis adjusted for repeated measures was used to model growth trends. RESULTS: Median z-score for weight was -0.7 at birth, -1.6 before bidirectional cavopulmonary shunt (BCPS), -0.7 before Fontan procedure, and -0.7 after Fontan procedure. A significant decline in z-scores for weight was seen before BCPS, which was reversed after the hemi-Fontan and stabilized after Fontan procedure. The z-scores for weight before the BCPS were lower in patients with lower birth weight (p < 0.01), nutritional difficulties (p = 0.01), and higher right atrial pressures (p = 0.02). After the BCPS, impaired growth was seen in patients who had systemic venous collaterals (p < 0.01). Patients who had collaterals embolized had the same growth trends as patients with no collaterals (p = 0.29). CONCLUSIONS: Infants with SV physiology show impaired somatic growth before BCPS. Although catch-up growth occurs after BCPS, effective interventions such as more intensive nutritional strategies before BCPS might be targeted at this high-risk population. The presence of systemic venous collaterals might impede growth secondary to hemodynamic impairment. Embolization of collaterals might allow for maximum growth potential.
Authors:
Kelly N Vogt; Cedric Manlhiot; Glen Van Arsdell; Jennifer L Russell; Seema Mital; Brian W McCrindle
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Publication Detail:
Type:  Journal Article     Date:  2007-10-23
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  50     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-05     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1876-83     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Pediatrics, University of Toronto, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Birth Weight / physiology
Body Height / physiology*
Body Weight / physiology*
Child
Child, Preschool
Dwarfism / physiopathology*
Female
Follow-Up Studies
Heart Catheterization
Heart Defects, Congenital / physiopathology*,  surgery
Heart Ventricles / abnormalities*,  physiopathology
Hemodynamics / physiology
Humans
Infant
Male
Oxygen / blood
Prognosis
Reoperation
Retrospective Studies
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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