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Related Experiment Videos

Somatic growth failure after the Fontan operation.

M I Cohen1, D M Bush, R J Ferry

  • 1Division of Cardiology, The Children' Hospital of Philadelphia and The University of Pennsylvania School of Medicine, 19104, USA. cohenmi@email.chop.edu

Cardiology in the Young
|October 26, 2000
PubMed
Summary

Children with single ventricle hearts undergoing staged Fontan palliation show improved but persistently low weight and height Z scores. These growth deficits remain significant compared to siblings and the general population.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Growth and Development

Background:

  • Congenital cardiac malformations often lead to growth failure.
  • Staged Fontan palliation aims to reduce hypoxemia and ventricular overload in functionally univentricular hearts.
  • The impact of this approach on somatic growth requires further investigation.

Purpose of the Study:

  • To characterize the medium-term growth patterns of children with functionally univentricular hearts after staged Fontan palliation.
  • To assess somatic growth following hemi-Fontan and modified Fontan operations.

Main Methods:

  • Retrospective review of 65 patients with functionally univentricular hearts who completed staged Fontan circulation between 1990-1995.
  • Growth parameters (weight, height) were measured pre-operatively and annually for three years post-Fontan.

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  • Comparison with sibling and parental growth data.

    • Main Results:

    • Mean weight Z score improved post-Fontan but remained below normal (-0.91 +/- 0.99).
    • Mean height Z scores at follow-up were significantly lower than parents and siblings (-1.15 +/- 1.2).
    • Persistent underweight and short stature were observed in this cohort.

    Conclusions:

    • Children palliated with staged Fontan operations for single ventricle physiology exhibit significant and persistent growth deficits.
    • Growth retardation remains a concern despite successful surgical palliation.
    • Further strategies may be needed to optimize growth in this population.