Key result
Systemic RV is linked to lower weight-for-age z-scores vs systemic LV pre- and post-Fontan.
Why the study?
Growth patterns in single ventricle children with systemic right versus left ventricles have not been compared longitudinally through key surgical stages.
Does having a systemic right ventricle compared to a systemic left ventricle affect somatic growth in single ventricle children?
Cohort (n=94)
No
Does having a systemic right ventricle compared to a systemic left ventricle affect somatic growth in single ventricle children?
Single ventricle children with a systemic left ventricle demonstrate better weight gain after the Glenn anastomosis compared to those with a systemic right ventricle.
Answers are grounded in this paper and cite their sources.
May support closer growth monitoring in systemic right ventricle patients; leaves open independent effects of ventricular morphology.
AIM: We sought to compare and assess growth in single ventricle children with a systemic right or left ventricle in five time periods: at birth, before neonatal surgery, before the Glenn anastomosis and finally before and after the Fontan operation to 11 years of age. METHODS: We reviewed medical records on 116 single ventricle patients operated at Rigshospitalet, Denmark from 1987 to 2007. Surgical procedures, feeding route, hemodynamic variables and anthropometric measurements such as weight and height were registered and converted to z-scores. RESULTS: Ninety four single ventricle patients were included for analysis. Gestational age and birth weight was not significantly different between the left and right ventricle group. Before neonatal surgery and before the Glenn anastomosis, both groups showed equal growth retardation. However, a significant difference in catch-up growth was found before the Fontan operation. Thus, patients in the right ventricle group had a smaller median weight-for-age z-score compared with the left ventricle group in the pre-Fontan period (-1.9 and -1.6; p = 0.049) and in the post-Fontan period (-1.1 and -0.7; p = 0.034). CONCLUSION: After the Glenn anastomosis single ventricle children with a systemic left ventricle have better weight gain compared with children with a systemic right ventricle.
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Hessel et al. (2012) conducted a cohort in Single ventricle (n=94). Systemic right ventricle vs. Systemic left ventricle was evaluated on Median weight-for-age z-score in the pre-Fontan period (p=0.049). Children with a systemic right ventricle had lower median weight-for-age z-scores than those with a systemic left ventricle pre-Fontan (-1.9 vs -1.6; p=0.049) and post-Fontan (-1.1 vs -0.7; p=0.034).
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