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Growth pattern of children with congenital heart disease before and after open heart surgery
Ahmad Jamei Khosroshahi1, Maryam Shoaran2, Shamsi Ghaffari1
1Pediatric Cardiology Department, Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Congenital heart disease (CHD) significantly impacts child growth, with open-heart surgery greatly reducing growth disorders. However, persistent challenges remain, especially for cyanotic CHD patients, necessitating targeted interventions.
Area of Science:
- Pediatric Cardiology
- Growth and Development
- Surgical Outcomes
Background:
- Congenital heart disease (CHD) affects 0.8%-1.2% of newborns globally, presenting significant growth and nutritional challenges.
- This study investigated growth patterns in 200 CHD patients (cyanotic and non-cyanotic) aged 1 month to 15 years before and after open-heart surgery.
Purpose of the Study:
- To assess the impact of open-heart surgery on growth patterns in children with congenital heart disease.
- To compare growth disorders between cyanotic and non-cyanotic CHD patient groups post-surgery.
Main Methods:
- Cross-sectional study of 200 CHD patients (1 month-15 years) from March 2016 to March 2020.
- Data collection included patient records, growth measurements, and surgical/postoperative outcomes.
- Logistic regression was used to compare growth disorders between cyanotic and non-cyanotic groups, adjusting for age and gender.
Main Results:
- Open-heart surgery significantly reduced weight, height, and head circumference growth disorders in CHD patients.
- Preoperative weight growth disorder prevalence decreased from 44% to 3.5% within 2 years post-surgery.
- While overall growth improved, cyanotic patients showed significantly higher residual weight and height growth disorders compared to non-cyanotic patients after 1 year.
Conclusions:
- Pediatric open-heart surgery improves growth in children with CHD, but long-term challenges persist, particularly in cyanotic cases.
- Persistent growth impairments can impact hospitalization duration and are associated with increased mortality risks.
- Targeted interventions are essential to mitigate growth-related complications in children with congenital heart disease.
Background:
Congenital heart disease (CHD) affects 0.8%-1.2% of newborns globally, posing challenges to growth and nutrition. This cross-sectional study, conducted at Shahid Madani Hospital, Tabriz, aimed to assess growth patterns in 200 CHD patients (cyanotic and non-cyanotic) aged 1 month to 15 years before and after open-heart surgery.
Methods:
Data were collected from March 2016 to March 2020, including patient records, growth measurements, surgical details, and postoperative outcomes. Patients were categorized into cyanotic and non-cyanotic groups. Inclusion criteria involved CHD patients undergoing surgery with 1-2 years of follow-up. To compare growth disorders between cyanotic and non-cyanotic groups, logistic regression was used, adjusting for age and gender. The significance level was set at 0.05 for statistical analysis.
Results:
A total of 200 patients suffered from CHD underwent growth disorder examination in before and after surgery. The prevalence of weight growth disorder reduced from 44% in preoperative to 3.5% in 2 years after surgery. Similarly, the height and head circumference growth disorders experienced reduction from 40.5% and 6.5% to 9.5% and 1.5%, respectively. Generally, growth disorders were higher in cyanotic compared to non-cyanotic group. However, this difference was only significant in weight and height growth disorders in cyanotic vs. non-cyanotic groups after 1 year from surgery (p = 0.024, 0.038). The duration of PICU (8.11 ± 5.47 vs. 8.84 ± 5.83 days) and ward (4.40 ± 3.46 vs. 3.57 ± 2.20 days) hospitalization was longer for non-cyanotic vs. cyanotic groups, both suffering from growth disorders.
Conclusion:
Despite advancements in pediatric cardiac surgery, CHD children face growth challenges, especially in the cyanotic group. Timely surgical intervention demonstrated improvements, but growth disorders persisted in the long term, impacting PICU and inpatient ward stays. Targeted interventions are crucial to mitigate mortality risks associated with growth impairments in CHD children.
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