Carlo Bilic, Helena Staehler, Carolin Niedermaier, Thibault Schaeffer, Magdalena Cuman, Paul Philipp Heinisch, Melchior Burri, Nicole Piber, Alfred Hager, Peter Ewert, Jürgen Hörer, Masamichi Ono
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Factors influencing somatic growth were analyzed.</p><p><strong>Results: </strong> Most frequent diagnosis and initial palliation were hypoplastic left heart syndrome (HLHS) (34%) and the Norwood procedure (51%), respectively. Median age and weight at TCPC were 2.0 (IQR: 1.7-2.5) years and 11.3 (10.5-12.7) kg, respectively. Median 519 days after TCPC, a significant increase in WAZ (-0.4 to -0.2, <i>p</i> < 0.001) was observed, but not in HAZ (-0.6 to -0.6, <i>p</i> = 0.38). Older age at TCPC (<i>p</i> < 0.001, odds ratio [OR]: 2.6) and HLHS (<i>p</i> = 0.007, OR: 2.2) were risks for low WAZ after TCPC. Older age at TCPC (<i>p</i> = 0.009, OR: 1.9) and previous Norwood procedure (<i>p</i> = 0.021, OR: 2.0) were risks for low HAZ after TCPC. Previous bidirectional cavopulmonary shunt (BCPS) was a protective factor for both WAZ (<i>p</i> = 0.012, OR: 0.06) and HAZ (<i>p</i> = 0.028, OR: 0.30) at TCPC.</p><p><strong>Conclusion: </strong> In patients undergoing TCPC at the age of 4 years or less, a significant catch-up growth was observed in WAZ after TCPC, but not in HAZ. Previous BCPS resulted to be a protective factor for a better somatic development at TCPC. HLHSs undergoing Norwood were considered as risks for somatic development after TCPC.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"366-374"},"PeriodicalIF":1.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development of Weight and Height Age z-Score after Total Cavopulmonary Connection.\",\"authors\":\"Carlo Bilic, Helena Staehler, Carolin Niedermaier, Thibault Schaeffer, Magdalena Cuman, Paul Philipp Heinisch, Melchior Burri, Nicole Piber, Alfred Hager, Peter Ewert, Jürgen Hörer, Masamichi Ono\",\"doi\":\"10.1055/a-2158-1119\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong> We aimed to analyze somatic growth of patients after total cavopulmonary connection (TCPC) as well as to identify factors influencing postoperative catch-up growth.</p><p><strong>Methods: </strong> A total of 309 patients undergoing TCPC at 4 years old or less between 1994 and 2021 were included. Weight for age z-score (WAZ) and height for age-z-score (HAZ) at TCPC and at postoperative time between 1 and 3 years were calculated. Factors influencing somatic growth were analyzed.</p><p><strong>Results: </strong> Most frequent diagnosis and initial palliation were hypoplastic left heart syndrome (HLHS) (34%) and the Norwood procedure (51%), respectively. Median age and weight at TCPC were 2.0 (IQR: 1.7-2.5) years and 11.3 (10.5-12.7) kg, respectively. Median 519 days after TCPC, a significant increase in WAZ (-0.4 to -0.2, <i>p</i> < 0.001) was observed, but not in HAZ (-0.6 to -0.6, <i>p</i> = 0.38). Older age at TCPC (<i>p</i> < 0.001, odds ratio [OR]: 2.6) and HLHS (<i>p</i> = 0.007, OR: 2.2) were risks for low WAZ after TCPC. Older age at TCPC (<i>p</i> = 0.009, OR: 1.9) and previous Norwood procedure (<i>p</i> = 0.021, OR: 2.0) were risks for low HAZ after TCPC. Previous bidirectional cavopulmonary shunt (BCPS) was a protective factor for both WAZ (<i>p</i> = 0.012, OR: 0.06) and HAZ (<i>p</i> = 0.028, OR: 0.30) at TCPC.</p><p><strong>Conclusion: </strong> In patients undergoing TCPC at the age of 4 years or less, a significant catch-up growth was observed in WAZ after TCPC, but not in HAZ. Previous BCPS resulted to be a protective factor for a better somatic development at TCPC. HLHSs undergoing Norwood were considered as risks for somatic development after TCPC.</p>\",\"PeriodicalId\":23057,\"journal\":{\"name\":\"Thoracic and Cardiovascular Surgeon\",\"volume\":\" \",\"pages\":\"366-374\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Thoracic and Cardiovascular Surgeon\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2158-1119\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thoracic and Cardiovascular Surgeon","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2158-1119","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/22 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目标： 我们旨在分析全腔肺动脉连接（TCPC）后患者的体细胞生长，并确定影响术后追赶生长的因素。方法： 1994年至2021年间，共有309名4岁或以下接受TCPC的患者被纳入。计算TCPC时和术后1至3年时的年龄-体重z评分（WAZ）和年龄-身高z评分（HAZ）。分析了影响体细胞生长的因素。结果： 最常见的诊断和最初的缓解分别是左心发育不良综合征（HLHS）（34%）和诺伍德手术（51%）。TCPC的中位年龄和体重分别为2.0（IQR:1.7-2.5）岁和11.3（10.5-12.7）kg。TCPC后中位519天，WAZ显著增加（-0.4至-0.2，p p = 0.38）。TCPC年龄较大（p p = 0.007、OR:2.2）是TCPC后低WAZ的风险。TCPC年龄较大（p = 0.009，OR:1.9）和之前的Norwood手术（p = 0.021、OR:2.0）是TCPC后低HAZ的风险。先前的双向腔肺分流（BCPS）是WAZ（p = 0.012，OR:0.06）和HAZ（p = 0.028，OR:0.30）。结论： 在4岁或以下接受TCPC的患者中，在TCPC后的WAZ中观察到显著的追赶生长，但在HAZ中没有观察到。先前的BCPS是TCPC更好的体细胞发育的保护因素。接受诺伍德治疗的HLHS被认为是TCPC后体细胞发育的风险。
Development of Weight and Height Age z-Score after Total Cavopulmonary Connection.
Objective: We aimed to analyze somatic growth of patients after total cavopulmonary connection (TCPC) as well as to identify factors influencing postoperative catch-up growth.
Methods: A total of 309 patients undergoing TCPC at 4 years old or less between 1994 and 2021 were included. Weight for age z-score (WAZ) and height for age-z-score (HAZ) at TCPC and at postoperative time between 1 and 3 years were calculated. Factors influencing somatic growth were analyzed.
Results: Most frequent diagnosis and initial palliation were hypoplastic left heart syndrome (HLHS) (34%) and the Norwood procedure (51%), respectively. Median age and weight at TCPC were 2.0 (IQR: 1.7-2.5) years and 11.3 (10.5-12.7) kg, respectively. Median 519 days after TCPC, a significant increase in WAZ (-0.4 to -0.2, p < 0.001) was observed, but not in HAZ (-0.6 to -0.6, p = 0.38). Older age at TCPC (p < 0.001, odds ratio [OR]: 2.6) and HLHS (p = 0.007, OR: 2.2) were risks for low WAZ after TCPC. Older age at TCPC (p = 0.009, OR: 1.9) and previous Norwood procedure (p = 0.021, OR: 2.0) were risks for low HAZ after TCPC. Previous bidirectional cavopulmonary shunt (BCPS) was a protective factor for both WAZ (p = 0.012, OR: 0.06) and HAZ (p = 0.028, OR: 0.30) at TCPC.
Conclusion: In patients undergoing TCPC at the age of 4 years or less, a significant catch-up growth was observed in WAZ after TCPC, but not in HAZ. Previous BCPS resulted to be a protective factor for a better somatic development at TCPC. HLHSs undergoing Norwood were considered as risks for somatic development after TCPC.
期刊介绍：
The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field.
Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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