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Published on: July 18, 2014
Short stature among children undergoing cardiac surgery for congenital heart defects
Catalina Le Roy1, Guillermo Larios2, Cristian Clavería2
1Nutrición Pediátrica, Departamento de Gastroenterología y Nutrición Pediátrica, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile. catalinaleroy@yahoo.es.
Insights
Short stature is common in children with congenital heart diseases (CHDs), affecting 21.1% of those studied. The frequency of short stature varied significantly based on the specific type of CHD and cardiac surgery performed.
Area of Science:
- Pediatric Cardiology
- Pediatric Endocrinology
- Clinical Nutrition
Background:
- Congenital heart diseases (CHDs) are associated with malnutrition and potential long-term growth deficits.
- Nutritional deficiencies in children with CHDs can lead to significant health complications, including short stature.
- Understanding growth patterns is crucial for managing children with CHDs.
Purpose of the Study:
- To determine the prevalence of short stature in children undergoing cardiac surgery for CHDs.
- To analyze the relationship between short stature and specific types of CHDs and surgical interventions.
Main Methods:
- Retrospective study including 640 children who underwent cardiac surgery between 2009 and 2013.
- Exclusion of preterm infants and those with genetic syndromes or other conditions causing nutritional compromise.
- Anthropometric assessment using WHO standards; short stature defined as height-for-age Z-score < -2 SD.
Main Results:
- Overall, 21.1% of children (135 out of 640) exhibited short stature.
- Short stature prevalence was higher in infants older than one month (24.1%) compared to newborns (11%).
- Increased frequency of short stature was noted in specific surgical repair groups, including atrioventricular canal, tetralogy of Fallot, hypoplastic left heart syndrome, and ventricular septal defect closure.
Conclusions:
- Short stature is a frequent complication in children with CHDs requiring cardiac surgery.
- The occurrence of short stature is influenced by the specific type of congenital heart defect and the surgical procedure undertaken.
- No significant association was found between short stature and cyanosis or univentricular physiology.
Introduction:
Children with congenital heart diseases (CHDs) suffer from malnutrition because of nutritional deficiencies, being short stature the possible long-term consequence.
Objective:
To describe the presence of short stature among children undergoing cardiac surgery for CHDs.
Population And Methods:
Retrospective study. Children undergoing cardiac surgery with cardiopulmonary bypass pump between 2009 and 2013 were included. Preterm infants, carriers of genetic syndromes or other disease with nutritional compromise were excluded. Demographic data, type of CHD, admission surgery and anthropometric assessment using the WHO standards were studied. Short stature was defined as lenght/height for age Z score < -2 standard deviations, by sex.
Results:
A total of 640 children were studied; 361 (56.4 %) were boys; median age: 8 months (IQR: 1.9; 34.6); 66 children underwent > 1 surgery; 27 of them (40.9 %) had hypoplasia of the left ventricle. There were 358 (55.9 %) infants with cyanotic CHDs, 196 (30.6 %) with univentricular physiology. The median HAZ was -0.9 (IQR: -1.9; -0.1); 135 (21.1 %) had a short stature, 11 % of newborn infants and 24.1 % of older than one month old. A higher frequency of short stature was observed in 4 out of 6 children who underwent complete repair of the atrioventricular canal, in 15 out of 39 infants with repair of tetralogy of Fallot, in 8 out of 25 infants with hypoplasia of the left ventricle subjected to Glenn procedure, and in 34 out of 103 with closure of the ventricular septal defect. No association or statistically significant difference was found between short stature and cyanosis or univentricular physiology.
Conclusions:
There is a high frequency of short stature among children with CHDs, with differences according to the type of CHD and cardiac surgery performed.
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