| Somatic growth in children with single ventricle physiology impact of physiologic state. | |
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MedLine Citation:
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PMID: 17980255 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Kelly N Vogt; Cedric Manlhiot; Glen Van Arsdell; Jennifer L Russell; Seema Mital; Brian W McCrindle |
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Publication Detail:
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Type: Journal Article Date: 2007-10-23 |
Journal Detail:
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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:
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Created Date: 2007-11-05 Completed Date: 2007-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1876-83 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Department of Pediatrics, University of Toronto, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Birth Weight
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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:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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