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Title:

Impact of calorie intake and weight gain after Norwood procedure on the outcome of stage II palliation.

Document type:
Journal Article
Author(s):
Staehler, Helena; Schaeffer, Thibault; Ruf, Bettina; Heinisch, Paul Philipp; Di Padua, Chiara; Burri, Melchior; Piber, Nicole; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi
Abstract:
BACKGROUND: This study aimed to assess the impact of caloric intake and weight-for-age-Z-score after the Norwood procedure on the outcome of bidirectional cavopulmonary shunt. METHODS: A total of 153 neonates who underwent the Norwood procedure between 2012 and 2020 were surveyed. Postoperative daily caloric intake and weight-for-age-Z-score up to five months were calculated, and their impact on outcome after bidirectional cavopulmonary shunt was analysed. RESULTS: Median age and weight at the Norwood procedure were 9 days and 3.2 kg, respectively. Modified Blalock-Taussig shunt was used in 95 patients and right ventricle to pulmonary artery conduit in 58. Postoperatively, total caloric intake gradually increased, whereas weight-for-age-Z-score constantly decreased. Early and inter-stage mortality before stage II correlated with low caloric intake. Older age (p = 0.023) at Norwood, lower weight (p < 0.001) at Norwood, and longer intubation (p = 0.004) were correlated with low weight-for-age-Z-score (< -3.0) at 2 months of age. Patients with weight-for-age-Z-score < -3.0 at 2 months of age had lower survival after stage II compared to those with weight-for-age-Z-score of -3.0 or more (85.3 versus 92.9% at 3 years after stage II, p = 0.017). There was no difference between inter-stage weight gain and survival after bidirectional cavopulmonary shunt between the shunt types. CONCLUSION: Weight-for-age-Z-score decreased continuously throughout the first 5 months after the Norwood procedure. Age and weight at Norwood and intubation time were associated with weight gain. Inter-stage low weight gain (Z-score < -3) was a risk for survival after stage II.
Journal title abbreviation:
Cardiol Young
Year:
2024
Journal volume:
34
Journal issue:
4
Pages contribution:
876-883
Fulltext / DOI:
doi:10.1017/S1047951123003736
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/37927221
Print-ISSN:
1047-9511
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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