Evaluation of growth pattern in children with congenital heart disease before and after open heart surgery

Abstract

Malnutrition and failure to thrive is one of the most common outcomes and clinical signs of congenital heart disease. The aim of this study was to evaluate the pattern of weight, height and head growth before and after open heart surgery in congenital cyanotic and acyanotic heart diseases. Materials and Methods: In this cross-sectional study, children from one month to 15 years old who were diagnosed with congenital heart disease in Shahid Madani Hospital in Tabriz from the beginning of 2016 to the end of 2019 for open heart surgery were included in the study. Sampling was completely random. The method of data collection was through reviewing patients' files and to collect information, the data collection form of children with congenital heart disease - developmental disorder, which was prepared for this purpose, was used. The checklist included age, diagnosis of congenital heart disease, type of surgery performed, weight and height and head circumference at birth and first preoperative visit and one and two years after surgery, duration of cardiopulmonary bypass, duration of hospital stay in PICU and ward, mortality Postoperative period and number of hospitalizations. Results: In this study, their mean (standard deviation) age was 2.6 (3.4±) years. At the preoperative visit, the rate of weight growth disorder was 39 (39.0%) of children with congenital cyanotic heart disease and 49 (49.0%) of non-cyanotic disease. Height growth disorder was also present in 46 children (46.0%) with cyanotic disease and 35 children (35.0%) with non-cyanotic disease.

In follow-up one year after surgery, 14 (7.90%) of cyanotic children and 4 (2.07%) of non-cyanotic patients had weight growth disorders. Height growth disorder was present one year after surgery in 12 children (6.77%) with cyanotic disease and 4 children (2.07%) with non-cyanotic disease. Two years after surgery, the number of children with weight growth disorder was 6 (3.38%) with cyanotic disease and 1 (0.51%) with non-cyanotic disease. There was also stunting in 12 children (6.77%) with cyanotic disease and 7 children (3.62%) with non-cyanotic disease. Of 88 children (44.0%) who had developmental disorders at the preoperative visit, the mean (standard deviation) duration of hospital stay in PICU was 8.11 (±5.47) days in cyanotic patients and 8.84 (±5.83) days in non-cyanotic patients. Also, the mean (standard deviation) duration of ward hospitalization in these patients was 4.40 (±3.46) days in cyanotic patients and 3.57 (±2.20) days in non-cyanotic patients. Among 30 children who died after surgery, 12 (52.17%) of patients who died with cyanotic disease and 3 (42.85%) of non-cyanotic patients had weight growth disorders. Height growth disorder was present in 9 children (39.13%) who died with cyanotic disease and 4 children (57.14%) with non-cyanotic disease. Also, 4 cases (17.39%) of the dead with cyanotic disease and 2 cases (25.57%) with non-cyanotic disease had growth disorders in the head circumference.