ESPE Abstracts (2022) 95 P1-323

ESPE2022 Poster Category 1 Growth and Syndromes (85 abstracts)

Assessment of linear growth and weight gain after early infantile surgical repair of tetralogy of Fallot (TOF)

Ashraf Soliman 1 , Hamdy Ali 1 , Haytham Yassen 2 , Nazla Mahmoud 1 & Maya Itani 1


1Hamad General Hospital, Doha, Qatar; 2Sidra Medicine, Doha, Qatar

The benefits of surgical repair on long term growth in children with tetralogy of Fallot (TOF) have been variable. Surgery undertaken beyond infancy has often been associated with a residual degree of growth impairment. Primary repair of during early infancy was adopted in many centres, if clinically indicated. We examined the effects of full early surgical correction of TOF on linear growth for 2 years postoperatively. Anthropometric data of infants with TOF before and after full surgical correction of TOF were collected and analyzed for 2 years. These infants underwent early surgical correction (at mean age = 4.5 +/- 2 months). Growth data included length, weight, weight for age SDS (WAZ), Length SDS (LAZ), and weight for length SDS(WLZ).

Results: Before surgery WAZ, LAZ and WLZ were significantly decreased in TOF vs normal infants. Two infants in the TOF group had WAZ, LAZ and WLZ < -2. After early surgical correction the WLZ increased significantly in the TOF and controls. Only 1infant with TOF had LAZ <2 and none had WAZ <-2. Infants with TOF grew in length at normal rate after surgery but without post- surgical catch-up in length. Despite improvement of WAZ and WLZ in the TOF group, their LAZ and WAZ were significantly lower compared to normal infants at 1.7 +/- 0.3 years.

Table 1 Growth data of infants with TOF before and after early surgical correction.
TOF   G age Weeks WAZ1 LAZ1 WLZ1
n =10 Mean 38.7 -0.84 -0.62 -0.99
  SD 1.29 0.91 1.56 0.98
Controls Mean 39.5 0.00* 0.24* 0.17*
n = 50 SD 1.20 0.78 0.90 1.01

Age 2 (yr.) WAZ2 LAZ2 WLZ2 D-LAZ D-WLZ
1.67 -0.59 -0.57 -0.22# 0.05 (0.76) #
0.43 1.34 1.56 1.06 1.81 1.32
1.76 0.56* 0.14* 0.7*# -0.12 0.50#
0.51 1.09 1.21 1.02 1.06 1.09

1= before surgery, 2= 1.7 +/- 0.3 years after surgery, *P<0.05 among groups, #P<0.05 after vs before surgery. D= delta change.

Conclusions: Early repair of TOF prevents growth delay associated with this form of cyanotic heart disease. Early infantile operation significantly improves weight gain and ensures normal linear growth.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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