Delay in surgical repair of congenital heart
lesions can lead to worsening of nutrition and
growth status of patients. Several reports have
documented encouraging results of early repair
of critical congenital heart defects in symptomatic
neonates and infants rather than palliative
operations13 and of primary surgical
closure of large ventricular septal defects.14 15
Table 3 Nutrition and growth status
Groups
aP (n = 26) ap (n = 5) cp (n = 42) cP (n = 16)
Nutrition
Normal 4 2 24 3
Mild malnutrition 12 3 13 4
Moderate malnutrition 8 0 3 5
Severe malnutrition 2 0 2 4
Failure to thrive 11 2 17 9
Malnutrition and growth failure in CHD 51
Downloaded from http://adc.bmj.com/ on September 10, 2016 - Published by group.bmj.com
It is well documented that malnutrition most
commonly aVects patients with pulmonary
hypertension, and the results of our study also
support this. Hypoxia and pulmonary hypertension
were investigated separately for their
eVect on nutrition and growth in previous
studies. As evidenced by our investigation,
stunting is more common than wasting in
cyanotic heart disease. Additionally, we also
showed that patients with cyanotic heart
disease accompanied by pulmonary hypertension
were most severely aVected in terms of
nutrition and growth. Both moderate to severe
malnutrition and failure to thrive were more
common in this group. Severity of their cardiac
lesions and malnutrition put this group of
patients at greater risk for operative morbidity
and mortality. Thus, a more intensive nutritional
treatment and early corrective surgery
should be considered to optimise the outcome