LONG-TERM GROWTH FOLLOWING NEONATAL ANATOMIC REPAIR OF TRANSPOSITION OF THE GREAT-ARTERIES

Despite generally normal prenatal growth, surviving infants with trans position of the great arteries (TGA) frequently develop severe and pro gressive growth impairment which is not always fully reversed by elect ive atrial repair within the first year of life. This study was undert aken to determine the effect of neonatal anatomic repair of TGA on lon g-term growth. Twenty-three children with uncomplicated TGA were follo wed for a mean of 60 (12-90) months after anatomic repair at a mean ag e of 11 (1-40) days. Standardized measurements of weight, height, and head circumference for both patients and normal siblings were expresse d as percentiles as well as in Z scores (in standard deviations from t he mean for age and sex) based on internationally recognized standards . At latest follow-up, 22 (96%) of the patients were above the 3rd per centile for weight arid 21 (91%) for both height and head circumferenc e, with 13 (57%), 11 (48%), and 13 (57%) above the 50th percentile for each respective parameter. The mean Z scores (+/- SD) for weight, hei ght, and head circumference for the patient group were -0.1 +/- 1.2, - 0.2 +/- 1.3, and -0.1 +/- 1.1, respectively, and did not differ signif icantly from those of the reference population (p > 0.05 for each comp arison). Paired comparisons of mean Z scores for each growth parameter with those of 35 normal siblings demonstrated no significant differen ce for weight or height and a small but significant difference for hea d circumference. Age at surgical repair (within the first 6 weeks of l ife), duration of follow-up and the development of moderate supravalva r pulmonary stenosis were not statistically related to long-term growt h. These results indicate that in patients without extracardiac abnorm alities, neonatal anatomic repair of uncomplicated TGA results in norm al long-term growth.