HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Pirooz Eghtesady Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Anderson, J. B. Articles by Marino, B. S. Search for Related Content PubMed Articles by Anderson, J. B. Articles by Marino, B. S. Related Collections Congenital - cyanotic

J Thorac Cardiovasc Surg 2009;138:397-404
© 2009 The American Association for Thoracic Surgery

Congenital Heart Disease

Lower weight-for-age z score adversely affects hospital length of stay after the bidirectional Glenn procedure in 100 infants with a single ventricle

^a Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
^b Division of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
^c Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
^d Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Received for publication September 29, 2008; revisions received December 15, 2008; accepted for publication February 16, 2009.

^_* Address for reprints: Jeffrey B. Anderson, MD, MPH, Division of Cardiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML2003, Cincinnati, OH 45259. (Email: jeffrey.anderson{at}cchmc.org).

Objective: Poor growth has been described in infants with a single ventricle; however, little is known regarding its effect on surgical outcomes. We sought to assess the effect of nutritional status at the time of the bidirectional Glenn procedure on short-term outcomes.

Methods: We performed a retrospective case series of children who underwent the bidirectional Glenn procedure at our institution between January 2001 and December 2007. Anthropometric measurements were recorded at the time of neonatal admission and the bidirectional Glenn procedure. Data from preoperative echocardiograms and cardiac catheterization were recorded. The primary outcome variable was length of hospital stay.

Results: Data on 100 infants were included for analysis. Age at the time of the bidirectional Glenn procedure was 5.1 months (range, 2.4–10 months). The median weight-for-age z score at birth was –0.4 (range, –2.6 to 3.2), and by the time of the bidirectional Glenn procedure, it had decreased to –1.3 (range, –3.9 to 0.6). In multivariable modeling longer postoperative hospital stays were predicted by lower weight-for-age z score (P = .02), younger age (P < .001), being fed through a gastrostomy tube (P = .01), and undergoing concomitant aortic arch reconstruction (P < .001) at the time of the bidirectional Glenn procedure.

Conclusions: There is suboptimal weight gain between neonatal discharge and the bidirectional Glenn procedure. A lower weight-for-age z score and younger age at the time of the bidirectional Glenn procedure affects length of hospital stay independent of hemodynamic or echocardiographic variables.

This article has been cited by other articles:

				B. Alsoufi, C. Manlhiot, A. Awan, F. Alfadley, M. Al-Ahmadi, A. Al-Wadei, B. W. McCrindle, and Z. Al-Halees Current outcomes of the Glenn bidirectional cavopulmonary connection for single ventricle palliation Eur J Cardiothorac Surg, January 26, 2012; (2012) ezr280v1. [Abstract] [Full Text] [PDF]

				K. G. Friedman, J. W. Salvin, D. Wypij, Y. Gurmu, E. A. Bacha, D. W. Brown, P. C. Laussen, and M. A. Scheurer Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation Eur J Cardiothorac Surg, October 1, 2011; 40(4): 1000 - 1006. [Abstract] [Full Text] [PDF]

				M. C. Wallace, J. Jaggers, J. S. Li, M. L. Jacobs, J. P. Jacobs, D. K. Benjamin, S. M. O'Brien, E. D. Peterson, P. B. Smith, and S. K. Pasquali Center Variation in Patient Age and Weight at Fontan Operation and Impact on Postoperative Outcomes Ann. Thorac. Surg., May 1, 2011; 91(5): 1445 - 1452. [Abstract] [Full Text] [PDF]

				J. B. Anderson, H. J. Kalkwarf, J. E. Kehl, P. Eghtesady, and B. S. Marino Low Weight-for-Age Z-Score and Infection Risk After the Fontan Procedure Ann. Thorac. Surg., May 1, 2011; 91(5): 1460 - 1466. [Abstract] [Full Text] [PDF]