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

Published online by Cambridge University Press:  10 January 2012

Fabio Carmona ,
Lucas S. Hatanaka ,
Marco A. Barbieri ,
Heloisa Bettiol ,
Roseli B. D. Toffano ,
Jacqueline P. Monteiro ,
Paulo H. Manso  and
Ana P. C. P. Carlotti
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
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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.

Keywords

Cardiac surgerynutritioncongenital heart diseasepaediatric cardiology
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 5 , 13 September 2012 , pp. 507 - 513
Copyright
Copyright © Cambridge University Press 2012

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