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Title:

Development of Weight and Height Age z-Score after Total Cavopulmonary Connection.

Document type:
Journal Article
Author(s):
Bilic, Carlo; Staehler, Helena; Niedermaier, Carolin; Schaeffer, Thibault; Cuman, Magdalena; Heinisch, Paul Philipp; Burri, Melchior; Piber, Nicole; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi
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.
Journal title abbreviation:
Thorac Cardiovasc Surg
Year:
2024
Journal volume:
72
Journal issue:
5
Pages contribution:
366-374
Fulltext / DOI:
doi:10.1055/a-2158-1119
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/37607685
Print-ISSN:
0171-6425
TUM Institution:
Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer); Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane); Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert); Klinik und Poliklinik für Urologie (Prof. Gschwend)
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