ESPE2022 Poster Category 1 Growth and Syndromes (85 abstracts)
Variable post-operative growth pattern in infants with transposition of great arteries (TGA) after neonatal arterial switch operation
Ashraf Soliman 1 , Hamdy Ali 1 , Nazla Mahmoud 1 , Maya Itani 1 & Haytham Yassen 2
1Hamad General Hospital, Doha, Qatar; 2Sidra Medicine, Doha, Qatar
The arterial switch operation (ASO) represents a remarkable success in the treatment of cyanotic congenital heart disease, with survival rates approaching 100%. The effect of infantile deep hypothermic circulatory arrest and hypoxia on post-operative linear growth is not studied. Growth data were recorded and analyzed in 12 infants with d-TGA who underwent switch operation (anatomical correction) in the early neonatal period for 18 months.
Results: After the operation, 5/12 crossed down Length centiles by 1 SD or more and 1 infant crossed up centiles > 1SD. 6/12 crossed down WAZ by 1 SD or more during the 18 months after surgery. 18 months after surgery 2 infants had WAZ< -1.5. One infant had HCZ <-2 at birth which improved markedly to -0.28 during 18 months after surgery. HCZ increased by 1 SDS or more in 3/12 infants after surgery and decreased by 1SD or more in 4/12 after surgery. None of the children had HCZ < -2 at 18 months of age. Weight/Length Z score (WLZ) was < -2 in 5/12 at birth and only in one infant 18 months after surgery. WLZ improved > 1SD in 7/12 of infants and decreased by 1 SD in one infant after surgery.
| patients | LAZ1 | LAZ2 | WAZ1 | WAZ2 | HC Z1 | HC Z2 | WLZ1 | WLZ2 |
| 1 | 2.08 | 1.18 | 0.87 | 2.53 | 0.35 | 0.07 | -1.58 | 2.57 |
| 2 | -0.03 | -1.03 | -0.16 | -0.13 | -1.24 | -0.18 | -0.37 | 0.57 |
| 3 | 0.1 | -0.5 | -1.1 | 1.05 | 0.02 | 0.75 | -2.15 | 1.42 |
| 4 | -0.17 | -0.85 | -0.43 | -1.75 | -1.67 | -0.71 | -0.63 | -1.69 |
| 5 | -0.71 | -1.14 | 0.05 | -1.67 | 0.45 | -0.67 | 0.8 | -1.53 |
| 6 | -0.12 | -1.73 | -1.4 | -3.27 | -1.24 | -1.93 | -2.52 | -2.45 |
| 7 | 0.22 | 1.39 | 0.92 | -0.1 | 1.06 | 0.7 | 1.02 | -1.22 |
| 8 | 0.93 | -0.23 | -0.14 | -0.05 | 0.35 | -0.69 | -1.94 | 0.08 |
| 9 | 1.44 | -0.65 | -0.31 | -1.27 | -0.82 | -2.13 | -2.29 | -1.33 |
| 10 | 2.61 | 1.89 | 2.01 | 0.51 | 1.14 | -0.11 | -0.46 | -0.52 |
| 11 | 0.5 | 0.25 | -0.04 | 0.53 | 0.35 | 0.15 | -0.87 | 0.54 |
| 12 | -2.14 | 0.06 | -3.76 | 0.22 | -3.61 | -0.28 | -4.35 | 0.24 |
| Mean | 0.39 | -0.11 | -0.29 | -0.28 | -0.41 | -0.42 | -1.28 | -0.28 |
| SD | 1.27 | 1.11 | 1.42 | 1.52 | 1.37 | 0.89 | 1.51 | 1.45 |
In conclusion Anatomical correction for d-TGA in the early neonatal period resulted in variable patterns of growth. The WLZ improved in most infants. None of the infants had LSDS or HCZ < -2 at 18 months. These data indicated acceptable linear growth, weight gain, and head growth in these infants.
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