Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-20T16:49:29.725Z Has data issue: false hasContentIssue false

Catch-up growth in children after repair of Tetralogy of Fallot

Published online by Cambridge University Press:  10 January 2012

Fabio Carmona*
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Lucas S. Hatanaka
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Marco A. Barbieri
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Heloisa Bettiol
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Roseli B. D. Toffano
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Jacqueline P. Monteiro
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Paulo H. Manso
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
Ana P. C. P. Carlotti
Affiliation:
Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
*
Correspondence to: Prof. F. Carmona, MD, Department of Paediatrics, Hospital das Clinicas of the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Avenida dos Bandeirantes, 3900, Campus Universitario, Monte Alegre, Ribeirao Preto, SP 14.049-900, Brazil. Tel: +551636022478; Fax: +551636022700; E-mail: carmona@fmrp.usp.br

Abstract

Purpose

To evaluate the growth of children after repair of Tetralogy of Fallot, as well as the influence of residual lesions and socio-economic status.

Methods

A total of 17 children, including 10 boys with a median age of 16 months at surgery, were enrolled in a retrospective cohort, in a tertiary care university hospital. Anthropometric (as z-scores), clinical, nutritional, and social data were collected.

Results

Weight-for-age and weight-for-height z-scores decreased pre-operatively and recovered post-operatively in almost all patients, most markedly weight for age. Weight-for-height z-scores improved, but were still lower than birth values in the long term. Long-term height-for-age z-scores were higher than those at birth, surgery, and 3 months post-operatively. Most patients showed catch-up growth for height for age (70%), weight for age (82%), and weight for height (70%). Post-operative residual lesions (76%) influenced weight-for-age z-scores. Despite the fact that most patients (70%) were from low-income families, energy intake was above the estimated requirement for age and gender in all but one patient. There was no influence of socio-economic status on pre- and post-operative growth. Bone age was delayed and long-term-predicted height was within mid-parental height limits in 16 children (93%).

Conclusion

Children submitted to Tetralogy of Fallot repair had pre-operative acute growth restriction and showed post-operative catch-up growth for weight and height. Acute growth restriction could still be present in the long term.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Mehrizi, A, Drash, A. Growth disturbance in congenital heart disease. J Pediatr 1962; 61: 418429.CrossRefGoogle ScholarPubMed
2.Feldt, RH, Strickler, GB, Weidman, WH. Growth of children with congenital heart disease. Am J Dis Child 1969; 117: 573579.CrossRefGoogle ScholarPubMed
3.Cameron, JW, Rosenthal, A, Olson, AD. Malnutrition in hospitalized children with congenital heart disease. Arch Pediatr Adolesc Med 1995; 149: 10981102.CrossRefGoogle ScholarPubMed
4.Venugopalan, P, Akinbami, FO, Al-Hinai, KM, Agarwal, AK. Malnutrition in children with congenital heart defects. Saudi Med J 2001; 22: 964967.Google ScholarPubMed
5.Vaidyanathan, B, Nair, SB, Sundaram, KR, et al. Malnutrition in children with congenital heart disease (CHD) determinants and short term impact of corrective intervention. Indian Pediatr 2008; 45: 541546.Google ScholarPubMed
6.Vaidyanathan, B, Radhakrishnan, R, Sarala, DA, Sundaram, KR, Kumar, RK. What determines nutritional recovery in malnourished children after correction of congenital heart defects? Pediatrics 2009; 124: e294e299.CrossRefGoogle ScholarPubMed
7.Hill, GL. Malnutrition and surgical risk: guidelines for nutritional therapy. Ann R Coll Surg Engl 1987; 69: 263265.Google ScholarPubMed
8.Haydock, DA, Hill, GL. Impaired wound healing in surgical patients with varying degrees of malnutrition. J Parenter Enteral Nutr 1986; 10: 550554.CrossRefGoogle ScholarPubMed
9.Gross, RL, Newberne, PM. Role of nutrition in immunologic function. Physiol Rev 1980; 60: 188302.CrossRefGoogle ScholarPubMed
10.Varan, B, Tokel, K, Yilmaz, G. Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension. Arch Dis Child 1999; 81: 4952.CrossRefGoogle ScholarPubMed
11.Sondheimer, JM, Hamilton, JR. Intestinal function in infants with severe congenital heart disease. J Pediatr 1978; 92: 572578.CrossRefGoogle ScholarPubMed
12.Thommessen, M, Heiberg, A, Kase, BF. Feeding problems in children with congenital heart disease: the impact on energy intake and growth outcome. Eur J Clin Nutr 1992; 46: 457464.Google ScholarPubMed
13.Leitch, CA, Karn, CA, Peppard, RJ, et al. Increased energy expenditure in infants with cyanotic congenital heart disease. J Pediatr 1998; 133: 755760.CrossRefGoogle ScholarPubMed
14.Manso, PH, Carmona, F, Jacomo, ADN, Bettiol, H, Barbieri, MA, Carlotti, APCP. Growth after ventricular septal defect repair: does defect size matter? A 10-year experience. Acta Paediatr 2010; 99: 13561360.CrossRefGoogle Scholar
15.Bernstein, D, Bell, JG, Kwong, L, Castillo, RO. Alterations in postnatal intestinal function during chronic hypoxemia. Pediatr Res 1992; 31: 234238.CrossRefGoogle ScholarPubMed
16.Dundar, B, Akcoral, A, Saylam, G, et al. Chronic hypoxemia leads to reduced serum IGF-I levels in cyanotic congenital heart disease. J Pediatr Endocrinol Metab 2000; 13: 431436.CrossRefGoogle ScholarPubMed
17.Cheung, MM, Davis, AM, Wilkinson, JL, Weintraub, RG. Long term somatic growth after repair of tetralogy of Fallot: evidence for restoration of genetic growth potential. Heart 2003; 89: 13401343.CrossRefGoogle ScholarPubMed
18.Schuurmans, FM, Pulles-Heintzberger, CF, Gerver, WJ, Kester, AD, Forget, PP. Long-term growth of children with congenital heart disease: a retrospective study. Acta Paediatr 1998; 87: 12501255.CrossRefGoogle ScholarPubMed
19.Reiter, EO, Rosenfeld, RG. Normal and aberrant growth. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR (eds.). Williams Textbook of Endocrinology. Elsevier, Philadelphia, 2008, pp. 853854.Google Scholar
20.Tanner, JM. The use and abuse of growth standards. In: Falkner F, Tanner JM (eds.). Human Growth. Plenum, New York, 1986, pp. 95112.Google Scholar
21.Niklasson, A, Albertsson-Wikland, K. Continuous growth reference from 24th week of gestation to 24 months by gender. BMC Pediatr 2008; 8: 8.CrossRefGoogle ScholarPubMed
22.Ong, KK, Preece, MA, Emmett, PM, Ahmed, ML, Dunger, DB. Size at birth and early childhood growth in relation to maternal smoking, parity and infant breast-feeding: longitudinal birth cohort study and analysis. Pediatr Res 2002; 52: 863867.CrossRefGoogle ScholarPubMed
23.Schofield, WN. Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 1985; 39 (Suppl 1): 541.Google ScholarPubMed
24.Avitzur, Y, Singer, P, Dagan, O, et al. Resting energy expenditure in children with cyanotic and noncyanotic congenital heart disease before and after open heart surgery. J Parenter Enteral Nutr 2003; 27: 4751.CrossRefGoogle ScholarPubMed
25.Menon, G, Poskitt, EM. Why does congenital heart disease cause failure to thrive? Arch Dis Child 1985; 60: 11341139.CrossRefGoogle ScholarPubMed
26.Nydegger, A, Bines, JE. Energy metabolism in infants with congenital heart disease. Nutrition 2006; 22: 697704.CrossRefGoogle ScholarPubMed
27.Steltzer, M, Rudd, N, Pick, B. Nutrition care for newborns with congenital heart disease. Clin Perinatol 2005; 32: 10171030.CrossRefGoogle ScholarPubMed
28.De Wit, B, Meyer, R, Desai, A, Macrae, D, Pathan, N. Challenge of predicting resting energy expenditure in children undergoing surgery for congenital heart disease. Pediatr Crit Care Med 2010; 11: 496501.Google ScholarPubMed
29.Nydegger, A, Walsh, A, Penny, DJ, Henning, R, Bines, JE. Changes in resting energy expenditure in children with congenital heart disease. Eur J Clin Nutr 2009; 63: 392397.CrossRefGoogle ScholarPubMed
30.Trumbo, P, Schlicker, S, Yates, AA, Poos, M. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc 2002; 102: 16211630.CrossRefGoogle ScholarPubMed