@Article{chd.12843,
AUTHOR = {Arene Butto, Laura Mercer‐Rosa, Christopher Teng, Carrie Daymont, Jonathan Edelson, Jennifer Faerber, Erika Mejia, Chitra Ravishankar, Meryl S. Cohen},
TITLE = {Longitudinal growth in patients with single ventricle cardiac disease receiving tube‐assisted feeds},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {6},
PAGES = {1058--1065},
URL = {http://www.techscience.com/schd/v14n6/38911},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Children with single ventricle cardiac disease (SVCD) have poor growth in 
early life. Tube‐assisted feeding (TF) is used to improve weight gain, but its impact on 
long‐term growth remains unknown. We sought to compare the longitudinal growth 
of SVCD patients receiving TF after initial cardiac surgery with those fed entirely by 
mouth.<br/>
<b>Design:</b> We conducted a retrospective cohort study of SVCD patients who under‐
went initial surgical palliation between 1999 and 2009. We defined TF as the use of 
nasogastric, gastrostomy, or jejunostomy TF. We compared maximal attained growth 
z‐scores for each year of life between TF and non‐TF patients. A secondary analysis 
compared surgical and clinical factors between groups.<br/>
<b>Results:</b> A total of 134 patients were included; 64% were male and 68% underwent 
the Norwood operation. One third of patients (44) received TF. Adjusting for age, 
TF patients had an average of 0.56 lower weight‐for‐age z‐score (WAZ) than non‐TF 
patients (P = 0.007) through the age of 6 years. Longitudinal height was not affected 
by TF status (P = 0.15). In a subanalysis of Norwood patients, TF patients had lower 
WAZ at initial hospital discharge despite longer LOS. TF patients had diminished 
WAZ after adjusting for complications, interstage hospitalizations, and timing of sub‐
sequent operations.<br/>
<b>Conclusions:</b> In this single‐center study, patients with SVCD requiring TF at discharge 
from initial surgical palliation had diminished WAZ at discharge and on long‐term fol‐
low‐up, despite controlling for other identifiable risk factors. Further investigation 
is needed to understand the mechanisms underlying this phenomenon and to risk 
stratify infants who go home on TF.},
DOI = {10.1111/chd.12843}
}