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Author Notes:

Correspondence to: George T. Nicholson, MD, Vanderbilt University Medical Center Pediatric Heart Institute, Thomas P. Graham Jr. Division of Pediatric Cardiology, 2200 Children's Way 5230 Doctors’ Office Tower Nashville, TN 37232. E‐mail:george.t.nicholson@vumc.org

We would like to thank Joelle Pettus for her continued role in the management of the Congenital Catheterization Research Collaborative (CCRC).

The CCRC would also like to acknowledge and thank the Children's Healthcare of Atlanta and Emory University Pediatrics Biostatics Collaboration Core for their continued expertise and support.

The authors have no disclosures to disclose.

Subject:

Research Funding:

This study was funded in part by generous support from the member institutions of the Congenital Catheterization Research Collaborative as well as the Kennedy Hammill Pediatric Cardiac Research Fund, The Liam Sexton Foundation, and A Heart Like Ava.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • congenital heart disease
  • outcomes research
  • surgery
  • SINGLE VENTRICLE PHYSIOLOGY
  • BLALOCK-TAUSSIG SHUNT
  • HEART-DISEASE
  • WEIGHT-GAIN
  • NUTRITIONAL-STATUS
  • CLINICAL-OUTCOMES
  • PRETERM INFANTS
  • CHILDREN
  • TERM
  • CHILDHOOD

Impact of Palliation Strategy on Interstage Feeding and Somatic Growth for Infants With Ductal-Dependent Pulmonary Blood Flow: Results from the Congenital Catheterization Research Collaborative

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Journal Title:

Journal of the American Heart Association

Volume:

Volume 9, Number 1

Publisher:

, Pages e013807-e013807

Type of Work:

Article | Final Publisher PDF

Abstract:

In infants with ductal-dependent pulmonary blood flow, the impact of palliation strategy on interstage growth and feeding regimen is unknown. Methods and Results: This was a retrospective multicenter study of infants with ductal-dependent pulmonary blood flow palliated with patent ductus arteriosus (PDA) stent or Blalock-Taussig shunt (BTS) from 2008 to 2015. Subjects with a defined interstage, the time between initial palliation and subsequent palliation or repair, were included. Primary outcome was change in weight-for-age Z-score. Secondary outcomes included % of patients on: all oral feeds, feeding-related medications, higher calorie feeds, and feeding-related readmission. Propensity score was used to account for baseline differences. Subgroup analysis was performed in 1- (1V) and 2-ventricle (2V) groups. The cohort included 66 PDA stent (43.9% 1V) and 195 BTS (54.4% 1V) subjects. Prematurity was more common in the PDA stent group (P=0.051). After adjustment, change in weight-for-age Z-score did not differ between groups over the entire interstage. However, change in weight-for-age Z-score favored PDA stent during the inpatient interstage (P=0.005) and BTS during the outpatient interstage (P=0.032). At initial hospital discharge, PDA stent treatment was associated with all oral feeds (P<0.001) and absence of feeding-related medications (P=0.002). Subgroup analysis revealed that 2V but not 1V patients demonstrated significant increase in weight-for-age Z-score. In the 2V cohort, feeding-related readmissions were more common in the BTS group (P=0.008). Conclusions: In infants with ductal-dependent pulmonary blood flow who underwent palliation with PDA stent or BTS, there was no difference in interstage growth. PDA stent was associated with a simpler feeding regimen and fewer feeding-related readmissions.

Copyright information:

© 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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