Somatic Growth in Children With Single Ventricle PhysiologyImpact of Physiologic State
Kelly N. Vogt, BSc*,
Cedric Manlhiot, BSc*,
Glen Van Arsdell, MD ,
Jennifer L. Russell, MD*,
Seema Mital, MD* and
Brian W. McCrindle, MD, MPH*,*
* Division of Cardiology, Department of Pediatrics, University of Toronto, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
Division of Cardiothoracic Surgery, Department of Surgery, University of Toronto, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
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Figure 1 Trends in Z-Scores for Weight Over Time
There was a significant decrease in z-scores for weight before bidirectional cavopulmonary shunt (BCPS) (p < 0.01). There was a significant increase in z-scores for weight in the pre-Fontan period (p < 0.01), which levels off after completion of the Fontan (p < 0.01).
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Figure 2 Trends in Z-Scores for Height Over Time
There was a small but significant increase in z-scores for height in the pre-Fontan period (p = 0.02). No significant change was seen in z-scores for height in the post-Fontan period (p = 0.29). BCPS = bidirectional cavopulmonary shunt.
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Figure 3 Trend in Z-Scores for Weight-for-Height Over Time
The z-scores for weight-for-height remained unchanged throughout the pre-bidirectional cavopulmonary shunt (BCPS) period. There was a significant increase in z-scores for weight-for-height in the pre-Fontan period (p = 0.01), which levels off after completion of the Fontan (p < 0.01).
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Figure 4 Effect of RA Pressure on Trends in Z-Scores for Weight Over Time Before the BCPS
Higher right atrial (RA) pressure was associated with greater decline in z-scores for weight from birth until the bidirectional cavopulmonary shunt (BCPS) (p = 0.02).
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Figure 5 Effect of Venous Collaterals on Z-Scores for Weight Over Time
Growth was impaired in patients with >2 collaterals in the pre-Fontan (p < 0.01) and in the post-Fontan (p = 0.01) period. No difference was seen between patients after embolization of collaterals and those who had <2 active collaterals (p = 0.89 pre-Fontan; p = 0.19 post-Fontan).
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