Growth retardation in cyanotic children after aorto-pulmonary shunt: due to a reduced growth in the first year of life?

Background:The influence of cyanosis, and cardiac index in children with cy anotic heart disease on their growth. Patients: 37 infants with cyanotic heart disease needing a systemico-pulmon ary anastomosis. Methods: Body weight, length, head circumference, body mass-index and trans cutaneous oxygen-saturation were measured (mean follow-up 610 days). In 25 children cardiac index was recorded by cardiac catheter before their next o peration. Results: At 9 months the percentiles had fallen from the 50th at birth to t he 3rd for body weight, 10th for length, 25th for head circumference and 25 th for the body mass-index. Growth-velocity normalized in the second year. Growth patterns were independent of the oxygen-saturation. Cardiac index wa s initially reduced but normalized during the 2nd year of life. Conclusion: Growth of infants with a systemico-pulmonary shunt was asymmetr ic. Growth velocity was reduced in the first year of life, and not influenc ed by the oxygen-saturation. A causal relationship between cardiac index an d decreased growth seems possible.