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Pattern of head circumference growth following bidirectional Glenn in infants with single ventricle heart disease

Published online by Cambridge University Press:  11 December 2020

Stephanie Y Tseng Open the ORCID record for Stephanie Y Tseng [Opens in a new window] ,
Julia Anixt ,
Jareen Meinzen-Derr ,
Cameron Thomas ,
David S Cooper  and
Haleh C Heydarian
Stephanie Y Tseng*
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Julia Anixt
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Jareen Meinzen-Derr
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Cameron Thomas
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
David S Cooper
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Haleh C Heydarian
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
*
Author for correspondence: Stephanie Y. Tseng, MD, The Heart Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH45229, USA. Tel: +1 513-636-7981; Fax: +1 513-803-4493. E-mail: Stephanie.Tseng@cchmc.org
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Abstract

Background:

Infants with single ventricle congenital heart disease demonstrate increasing head growth after bidirectional Glenn; however, the expected growth trajectory has not been well described.

Aims:

1) We will describe the pattern of head circumference growth in the first year after bidirectional Glenn. 2) We will determine if head growth correlates with motor developmental outcomes approximately 12 months after bidirectional Glenn.

Methods:

Sixty-nine single ventricle patients underwent bidirectional Glenn between 2010 and 2016. Patients with structural brain abnormalities, grade III–IV intra-ventricular haemorrhage, significant stroke, or obstructive hydrocephalus were excluded. Head circumference and body weight measurements from clinical encounters were evaluated. Motor development was measured with Psychomotor Developmental Index of the Bayley Scales of Infant Development, Third Edition. Generalised estimating equations assessed change in head circumference z-scores from baseline (time of bidirectional Glenn) to 12 months post-surgery.

Results:

Mean age at bidirectional Glenn was 4.7 (2.3) months and mean head circumference z-score based on population-normed data was −1.13 (95% CI −1.63, −0.63). Head circumference z-score increased to 0.35 (95% CI −0.20, 0.90) (p < 0.0001) 12 months post-surgery. Accelerated head growth, defined as an increase in z-score of >1 from baseline to 12 months post-surgery, was present in 46/69 (66.7%) patients. There was no difference in motor Psychomotor Developmental Index scores between patients with and without accelerated head growth.

Conclusion:

Single ventricle patients demonstrated a significant increase in head circumference after bidirectional Glenn until 10–12 months post-surgery, at which time growth stabilised. Accelerated head growth did not predict sub-sequent motor developmental outcomes.

Keywords

Congenital heart diseasesingle ventriclebidirectional Glennhead circumferencemotor development
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 4 , April 2021 , pp. 609 - 616
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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