Relationship between age at repair surgery and growth and development of children with acyanotic congenital heart disease: a cross-sectional study

Muhammad Zulfadli Nuralim; Heroe Soebroto; Irwanto; Ito Puruhito

doi:10.15562/bmj.v12i1.4205

Relationship between age at repair surgery and growth and development of children with acyanotic congenital heart disease: a cross-sectional study

Muhammad Zulfadli Nuralim ,

Heroe Soebroto ,

Irwanto ,

Ito Puruhito ,

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DOI: https://doi.org/10.15562/bmj.v12i1.4205 |
Published: 2023-03-06

Abstract

Background: The survival of children with congenital heart disease (CHD) has increased drastically in the last few decades. However, in children with the acyanotic type of CHD, it is often accompanied by symptoms of failure to thrive. This study aims to assess the correlation between age at repair surgery and the growth and development of children with acyanotic CHD.

Method: A cross-sectional study was conducted on eligible patients with acyanotic CHD who had undergone heart repair procedures. Age was taken when the patient was preoperatively repaired and categorized based on the age range of 3 months to 5 years. According to the WHO curve (weight/height), growth is assessed from nutritional status. Development was assessed from the category of height (cm) after surgery. Differences in growth and development before and after repair surgery were tested using the Wilcoxon method.

Results: Of the 40 samples analyzed, there were 20 males and 20 females, the majority aged 3-4 years (25%) followed by ages 2-3 years (10%). There was an effect of repair surgery on growth when surgery was performed at 2 to 3 years with a p-value of 0.016 (<0.05). In the development category, there was no effect of surgery on development in all age categories, with a p-value of 0.424 (>0.05).

Conclusion: Surgery at an early age has better growth outcomes, especially at 2-3 years, but is unrelated to developmental aspects.

References

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Hussain MA, Al Mamun A, Peters SA, Woodward M, Huxley RR. The Burden of Cardiovascular Disease Attributable to Major Modifiable Risk Factors in Indonesia. J Epidemiol. 2016;26(10):515-521. doi:10.2188/jea.JE20150178.
Fedora K, Utamayasa IKA, Purwaningsih S. Profile of Acyanotic Congenital Heart Defect in Children at Dr. Soetomo General Hospital Surabaya Period of January – December 2016. JUXTA JIMK Univ Airlangga. 2019;10(2). p79-82. doi:10.20473/juxta.V10I22019.79-83.
Mari MA, Cascudo MM, Alchieri JC. Congenital Heart Disease and Impacts on Child Development. Braz J Cardiovasc Surg. 2016;31(1):31-37. doi:10.5935/1678-9741.20160001.
Pambudi J, Dhamayanti M, Kuswiyanto RB. Growth and Development in Children with Cyanotic and Acyanotic Congenital Heart Disease. Sari Pediatri. 2019;21(2). p102-108. doi:10.14238/sp21.2.2019.102-8.
Marino BS, Lipkin PH, Newburger JW, et al. Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management: A Scientific Statement From the American Heart Association. Circulation. 2012;126(9). p1143-1172. doi:10.1161/CIR.0b013e318265ee8a.
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Steurer MA, Peyvandi S, Costello JM, et al. Association between Z-score for birth weight and postoperative outcomes in neonates and infants with congenital heart disease. J Thorac Cardiovasc Surg. 2021;162(6):1838-1847.e4. doi:10.1016/j.jtcvs.2021.01.065.
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Tsuda T, Davies RR, Radtke W, Pizarro C, Bhat AM. Early Surgical Closure of Atrial Septal Defect Improves Clinical Status of Symptomatic Young Children with Underlying Pulmonary Abnormalities. Pediatr Cardiol. 2020;41(6):1115-1124. doi:10.1007/s00246-020-02361-8.

[1] Colombo JN, McCulloch MA. Acyanotic Congenital Heart Disease: Left-to-Right Shunt Lesions. NeoReviews. 2018;19(7). p375-383. doi:10.1542/neo.19-7-e375.

[2] Hussain MA, Al Mamun A, Peters SA, Woodward M, Huxley RR. The Burden of Cardiovascular Disease Attributable to Major Modifiable Risk Factors in Indonesia. J Epidemiol. 2016;26(10):515-521. doi:10.2188/jea.JE20150178.

[3] Fedora K, Utamayasa IKA, Purwaningsih S. Profile of Acyanotic Congenital Heart Defect in Children at Dr. Soetomo General Hospital Surabaya Period of January – December 2016. JUXTA JIMK Univ Airlangga. 2019;10(2). p79-82. doi:10.20473/juxta.V10I22019.79-83.

[4] Mari MA, Cascudo MM, Alchieri JC. Congenital Heart Disease and Impacts on Child Development. Braz J Cardiovasc Surg. 2016;31(1):31-37. doi:10.5935/1678-9741.20160001.

[5] Pambudi J, Dhamayanti M, Kuswiyanto RB. Growth and Development in Children with Cyanotic and Acyanotic Congenital Heart Disease. Sari Pediatri. 2019;21(2). p102-108. doi:10.14238/sp21.2.2019.102-8.

[6] Marino BS, Lipkin PH, Newburger JW, et al. Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management: A Scientific Statement From the American Heart Association. Circulation. 2012;126(9). p1143-1172. doi:10.1161/CIR.0b013e318265ee8a.

[7] Goldberg CS, Hu C, Brosig C, et al. Behavior and Quality of Life at 6 Years for Children With Hypoplastic Left Heart Syndrome. Pediatrics. 2019;144(5):e20191010. doi:10.1542/peds.2019-1010.

[8] Lopes SAVDA, Guimarães ICB, Costa SFO, Acosta AX, Sandes KA, Mendes CMC. Mortality for Critical Congenital Heart Diseases and Associated Risk Factors in Newborns. A Cohort Study. Arq Bras Cardiol. 2018;111(5):666-673. doi:10.5935/abc.20180175.

[9] Park M, Salamat M. Park’s Pediatric Cardiology for Practitioners - ClinicalKey 7th edition. Elsevier. 2020.

[10] Jenkins KJ, Botto LD, Correa A, et al. Public Health Approach to Improve Outcomes for Congenital Heart Disease Across the Life Span. J Am Heart Assoc. 2019;8(8):e009450. doi:10.1161/JAHA.118.009450.

[11] Djer MM, Madiyono B. Management of Congenital Heart Disease. Sari Pediatri. 2016;2(3). p155-162. doi:10.14238/sp2.3.2000.155-62.

[12] Li L, Li K, An C, et al. Identification of risk factors affecting catch-up growth after infant congenital heart disease surgery: rationale and design of a multicentre prospective cohort study in China. BMJ Open. 2019;9(8):e030084. Published 2019 Aug 20. doi:10.1136/bmjopen-2019-030084.

[13] Limperopoulos C, Majnemer A, Shevell MI, et al. Predictors of developmental disabilities after open heart surgery in young children with congenital heart defects. J Pediatr. 2002;141(1):51-58. doi:10.1067/mpd.2002.125227.

[14] Steurer MA, Peyvandi S, Costello JM, et al. Association between Z-score for birth weight and postoperative outcomes in neonates and infants with congenital heart disease. J Thorac Cardiovasc Surg. 2021;162(6):1838-1847.e4. doi:10.1016/j.jtcvs.2021.01.065.

[15] Shi H, Hu C, Zhang L, Tong M, Li L, Cui Y. Early Growth Trajectory of Infants With Simple Congenital Heart Disease and Complex Congenital Heart Disease Undergoing Cardiac Repair: A Prospective Cohort Study in China. JPEN J Parenter Enteral Nutr. 2021;45(6):1181-1191. doi:10.1002/jpen.2017.

[16] Wang TY, Park C, Zhang H, et al. Management of Acute Traumatic Spinal Cord Injury: A Review of the Literature. Front Surg. 2021;8:698736. doi:10.3389/fsurg.2021.698736.

[17] Fuller S, Rajagopalan R, Jarvik GP, et al. J. Maxwell Chamberlain Memorial Paper for congenital heart surgery. Deep hypothermic circulatory arrest does not impair neurodevelopmental outcome in school-age children after infant cardiac surgery. Ann Thorac Surg. 2010;90(6):1985-1995. doi:10.1016/j.athoracsur.2010.08.005.

[18] Tsuda T, Davies RR, Radtke W, Pizarro C, Bhat AM. Early Surgical Closure of Atrial Septal Defect Improves Clinical Status of Symptomatic Young Children with Underlying Pulmonary Abnormalities. Pediatr Cardiol. 2020;41(6):1115-1124. doi:10.1007/s00246-020-02361-8.

Relationship between age at repair surgery and growth and development of children with acyanotic congenital heart disease: a cross-sectional study

Abstract

References

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