Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 13
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Burch, Phillip T. Spigarelli, Michael G. Lambert, Linda M. Loftus, Patrick D. Sherwin, Catherine M. Linakis, Matthew W. Sheng, Xiaoming LuAnn Minich, L. and Williams, Richard V. 2016. Use of Oxandrolone to Promote Growth in Neonates following Surgery for Complex Congenital Heart Disease: An Open-Label Pilot Trial. Congenital Heart Disease,

    Fogg, Kristi L. DellaValle, Diane M. Buckley, Jason R. Graham, Eric M. and Zyblewski, Sinai C. 2016. Feasibility and Efficacy of Defatted Human Milk in the Treatment for Chylothorax After Cardiac Surgery in Infants. Pediatric Cardiology, Vol. 37, Issue. 6, p. 1072.

    Hansson, L. Öhlund, I. Lind, T. Stecksén-Blicks, C. and Rydberg, A. 2016. Dietary intake in infants with complex congenital heart disease: a case-control study on macro- and micronutrient intake, meal frequency and growth. Journal of Human Nutrition and Dietetics, Vol. 29, Issue. 1, p. 67.

    Karpen, Heidi E. 2016. Nutrition in the Cardiac Newborns. Clinics in Perinatology, Vol. 43, Issue. 1, p. 131.

    Medoff-Cooper, Barbara Irving, Sharon Y. Hanlon, Alexandra L. Golfenshtein, Nadya Radcliffe, Jerilynn Stallings, Virginia A. Marino, Bradley S. and Ravishankar, Chitra 2016. The Association among Feeding Mode, Growth, and Developmental Outcomes in Infants with Complex Congenital Heart Disease at 6 and 12 Months of Age. The Journal of Pediatrics, Vol. 169, p. 154.

    Fogg, K. L. and Zyblewski, S. C. 2015. Nutrition and Growth in Neonates Undergoing Cardiac Surgery. NeoReviews, Vol. 16, Issue. 3, p. e144.

    Onwubiko, Chinwendu Bairdain, Sigrid Murphy, Andrew J. McSweeney, Maireade E. Perkins, Julia Rathod, Rahul H. Baird, Christopher and Smithers, C. Jason 2015. Laparoscopic Gastrojejunostomy Tube Placement in Infants with Congenital Cardiac Disease. Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol. 25, Issue. 12, p. 1047.

    Davies, Ryan R. Carver, Stephanie W. Schmidt, Richard Keskeny, Heather Hoch, Jeanine and Pizarro, Christian 2014. Laryngopharyngeal dysfunction independent of vocal fold palsy in infants after aortic arch interventions. The Journal of Thoracic and Cardiovascular Surgery, Vol. 148, Issue. 2, p. 617.

    Toole, Benjamin J. Toole, Lindsay E. Kyle, Ursula G. Cabrera, Antonio G. Orellana, Renán A. and Coss-Bu, Jorge A. 2014. Perioperative Nutritional Support and Malnutrition in Infants and Children with Congenital Heart Disease. Congenital Heart Disease, Vol. 9, Issue. 1, p. 15.

    Irving, Sharon Y. Medoff-Cooper, Barbara Stouffer, Nicole O. Schall, Joan I. Ravishankar, Chitra Compher, Charlene W. Marino, Bradley S. and Stallings, Virginia A. 2013. Resting Energy Expenditure at 3 Months of Age Following Neonatal Surgery for Congenital Heart Disease. Congenital Heart Disease, Vol. 8, Issue. 4, p. 343.

    McCrary, Andrew W. Clabby, Martha L. and Mahle, William T. 2013. Patient and practice factors affecting growth of infants with systemic-to-pulmonary shunt. Cardiology in the Young, Vol. 23, Issue. 04, p. 499.

    Medoff-Cooper, Barbara and Ravishankar, Chitra 2013. Nutrition and growth in congenital heart disease. Current Opinion in Cardiology, Vol. 28, Issue. 2, p. 122.

    Nicholson, George T. Clabby, Martha L. Kanter, Kirk R. and Mahle, William T. 2013. Caloric Intake During the Perioperative Period and Growth Failure in Infants With Congenital Heart Disease. Pediatric Cardiology, Vol. 34, Issue. 2, p. 316.


Poor post-operative growth in infants with two-ventricle physiology

  • Jeffrey B. Anderson (a1), Bradley S. Marino (a1) (a2), Sharon Y. Irving (a3), J. Felipe García-España (a4), Chitra Ravishankar (a4), Virginia A. Stallings (a5) and Barbara Medoff-Cooper (a3) (a6)
  • DOI:
  • Published online: 09 March 2011

Adequate nutritional support is essential for normal infant growth and development. Infants with congenital cardiac disease are known to be at risk for growth failure. We sought to describe perioperative growth in infants undergoing surgical repair of two-ventricle congenital cardiac disease and assess for predictors of their pattern of growth.

Materials and methods

Full-term infants who underwent surgical repair of two-ventricle congenital cardiac disease at a single institution were enrolled in a retrospective cohort study performed following a larger prospective study. Infants with facial, gastrointestinal, or neurologic anomalies, trisomy chromosomal abnormality, birth weight less than 2500 grams, or those transferred to another institution before discharge home were excluded. The primary outcome was change in weight-for-age z score from surgery to discharge. Our secondary outcome variable was post-operative hospital length of stay.


A total of 76 infants met the inclusion criteria. Medain age at surgery was 5 days with a range from 1 to 44. The median weight-for-age z score at surgery was −0.2 with a range from −2.9 to 2.8 and by discharge had dropped to −1.2 with a range from −3.4 to 1.8. The median change in weight-for-age z score from surgery to discharge was −1.0 with a range from −2.3 to 0.2. Delayed post-operative nutrition (p < 0.001) and reintubation following initial post-operative extubation (p = 0.001) were associated with decrease in weight-for-age z score.


Infants undergoing repair of two-ventricle congenital cardiac disease had poor growth in the post-operative period. This may be mitigated by early initiation of post-operative nutrition.

Corresponding author
Correspondence to: J. B. Anderson, MD, MPH, Division of Cardiology, Department of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2003, Cincinnati, 45255 Ohio, United States of America. Tel: 513 636 3865; Fax: 513 636 3952; E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1.J Argyle . Approaches to detecting growth faltering in infancy and childhood. Ann Hum Biol 2003; 30: 499519.

2.MC Rudolf , S Logan . What is the long term outcome for children who fail to thrive? A systematic review. Arch Dis Child 2005; 90: 925931.

4.MM Black , H Dubowitz , A Krishnakumar , RH Starr Jr. Early intervention and recovery among children with failure to thrive: follow-up at age 8. Pediatrics 2007; 120: 5969.

5.RA Dykman , PH Casey , PT Ackerman , WB McPherson . Behavioral and cognitive status in school-aged children with a history of failure to thrive during early childhood. Clin Pediatr (Phila) 2001; 40: 6370.

6.JI Hoffman , S Kaplan . The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 18901900.

7.ML Forchielli , R McColl , WA Walker , C Lo . Children with congenital heart disease: a nutrition challenge. Nutr Rev 1994; 52: 348353.

8.G Menon , EM Poskitt . Why does congenital heart disease cause failure to thrive? Arch Dis Child 1985; 60: 11341139.

9.N Vaisman , T Leigh , H Voet , K Westerterp , M Abraham , R Duchan . Malabsorption in infants with congenital heart disease under diuretic treatment. Pediatr Res 1994; 36: 545549.

12.B Vaidyanathan , SJ Roth , K Gauvreau , K Shivaprakasha , SG Rao , RK Kumar . Somatic growth after ventricular septal defect in malnourished infants. J Pediatr 2006; 149: 205209.

13.WT Mahle , TL Spray , G Wernovsky , JW Gaynor , BJ Clark 3rd. Survival after reconstructive surgery for hypoplastic left heart syndrome: a 15-year experience from a single institution. Circulation 2000; 102: III136III141.

14.C Wright , K Parkinson . Postnatal weight loss in term infants: what is “normal” and do growth charts allow for it? Arch Dis Child 2004; 89: 254257.

15.RK Cribbs , KF Heiss , ML Clabby , ML Wulkan . Gastric fundoplication is effective in promoting weight gain in children with severe congenital heart defects. J Pediatr Surg 2008; 43: 283289.

16.D Davis , S Davis , K Cotman , Feeding difficulties and growth delay in children with hypoplastic left heart syndrome versus d-transposition of the great arteries. Pediatr Cardiol 2008; 29: 328333.

17.LT Eskedal , PS Hagemo , E Seem , Impaired weight gain predicts risk of late death after surgery for congenital heart defects. Arch Dis Child 2008; 93: 495501.

18.CR Schwalbe-Terilli , DH Hartman , ML Nagle , Enteral feeding and caloric intake in neonates after cardiac surgery. Am J Crit Care 2009; 18: 5257.

19.F Lacour-Gayet , DR Clarke . The Aristotle method: a new concept to evaluate quality of care based on complexity. Curr Opin Pediatr 2005; 17: 412417.

20.KJ Jenkins . Risk adjustment for congenital heart surgery: the RACHS-1 method. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004; 7: 180184.

22.DK Kelleher , P Laussen , A Teixeira-Pinto , C Duggan . Growth and correlates of nutritional status among infants with hypoplastic left heart syndrome (HLHS) after stage 1 Norwood procedure. Nutrition 2006; 22: 237244.

23.JB Anderson , RH Beekman 3rd, P Eghtesady , Predictors of poor weight gain in infants with a single ventricle. J Pediatr 2010; 157: 407413.

24.MS Agus , T Jaksic . Nutritional support of the critically ill child. Curr Opin Pediatr 2002; 14: 470481.

25.RJ Shulman , S Phillips . Parenteral nutrition in infants and children. J Pediatr Gastroenterol Nutr 2003; 36: 587607.

26.JL Owens , N Musa . Nutrition support after neonatal cardiac surgery. Nutr Clin Pract 2009; 24: 242249.

27.AB Madhok , K Ojamaa , V Haridas , VA Parnell , S Pahwa , D Chowdhury . Cytokine response in children undergoing surgery for congenital heart disease. Pediatr Cardiol 2006; 27: 408413.

28.DS Cooper , MA Nichter . Advances in cardiac intensive care. Curr Opin Pediatr 2006; 18: 503511.

29.R Meyer , S Harrison , S Sargent , P Ramnarayan , P Habibi , D Labadarios . The impact of enteral feeding protocols on nutritional support in critically ill children. J Hum Nutr Diet 2009; 22: 428436.

30.BE Kogon , V Ramaswamy , K Todd , Feeding difficulty in newborns following congenital heart surgery. Congenit Heart Dis 2007; 2: 332337.

31.D Boethig , KJ Jenkins , H Hecker , WR Thies , T Breymann . The RACHS-1 risk categories reflect mortality and length of hospital stay in a large German pediatric cardiac surgery population. Eur J Cardiothorac Surg 2004; 26: 1217.

32.SH Larsen , J Pedersen , J Jacobsen , SP Johnsen , OK Hansen , V Hjortdal . The RACHS-1 risk categories reflect mortality and length of stay in a Danish population of children operated for congenital heart disease. Eur J Cardiothorac Surg 2005; 28: 877881.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
Please enter your name
Please enter a valid email address
Who would you like to send this to? *