Title

Impact of Palliation Strategy on Interstage Feeding and Somatic Growth for Infants With Ductal-Dependent Pulmonary Blood Flow: Results from the Congenital Catheterization Research Collaborative.

Year of Publication

2020

Number of Pages

e013807

Date Published

2020 Jan 07

ISSN Number

2047-9980

Abstract

<p><strong>Background</strong> In infants with ductal-dependent pulmonary blood flow, the impact of palliation strategy on interstage growth and feeding regimen is unknown.</p>

<p><strong>Methods and Results</strong> This was a retrospective multicenter study of infants with ductal-dependent pulmonary blood flow palliated with patent ductus arteriosus (PDA) stent or Blalock-Taussig shunt (BTS) from 2008 to 2015. Subjects with a defined interstage, the time between initial palliation and subsequent palliation or repair, were included. Primary outcome was change in weight-for-age -score. Secondary outcomes included % of patients on: all oral feeds, feeding-related medications, higher calorie feeds, and feeding-related readmission. Propensity score was used to account for baseline differences. Subgroup analysis was performed in 1- (1V) and 2-ventricle (2V) groups. The cohort included 66 PDA stent (43.9% 1V) and 195 BTS (54.4% 1V) subjects. Prematurity was more common in the PDA stent group (=0.051). After adjustment, change in weight-for-age -score did not differ between groups over the entire interstage. However, change in weight-for-age -score favored PDA stent during the inpatient interstage (=0.005) and BTS during the outpatient interstage (=0.032). At initial hospital discharge, PDA stent treatment was associated with all oral feeds (&lt;0.001) and absence of feeding-related medications (=0.002). Subgroup analysis revealed that 2V but not 1V patients demonstrated significant increase in weight-for-age -score. In the 2V cohort, feeding-related readmissions were more common in the BTS group (=0.008).</p>

<p><strong>Conclusions </strong>In infants with ductal-dependent pulmonary blood flow who underwent palliation with PDA stent or BTS, there was no difference in interstage growth. PDA stent was associated with a simpler feeding regimen and fewer feeding-related readmissions.</p>

DOI

10.1161/JAHA.119.013807

Alternate Title

J Am Heart Assoc

PMID

31852418

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