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• W4384566617 abstract "<h3>Objectives</h3> Infants who are born with congenital heart disease (CHD) face specific challenges with feeding and thriving and malnutrition is common.¹ Factors contributing to poor growth include increased metabolic demands and inadequate calorie intake.^{1 2} The optimal time for surgical repair of complete AVSD (cAVSD) or VSD is between 3 and 6 months of life however the timing of surgery is also based on an optimal target weight of 5kg.^{3 4} We aimed to describe the specific dietetic intervention strategies required to optimise growth and nutrition in infants born with cAVSD and VSD prior to their cardiac surgery. <h3>Methods</h3> The Children’s Health Ireland at Crumlin NICOR database was searched for patients who had surgical repair of cAVSD or VSD in their first year of life between 1st January 2019 – 31st December 2020. Recognising the additional challenges of hypotonia, infants with chromosomal anomalies were excluded from analysis. Retrospective chart review was undertaken to obtain demographic, medical and nutritional data. <h3>Results</h3> Fifty patients with a normal chromosome complement met inclusion criteria. The majority 40/50 (80%) of infants required calorie supplementation with nutrient dense formula or fortifier pre-operatively. Nasogastric tube (NGT) placement was required in more than half of infants 26/50 (52%) for indications including inadequate volume intake and poor weight gain. Ten patients 10/50, (20%) were still receiving some breastmilk at surgery. A minority of patients in our cohort (2/50, 4%) were exclusively breastfed at time of surgery. On average, 3.5 dietetic contacts were required to wean NGT post cardiac surgery. <h3>Conclusion</h3> Infants born with cAVSD and VSD have significant additional nutritional requirements and specialist MDT input is required to optimise their growth in order to achieve target weights for surgical intervention. Parents and caregivers should be counselled about the expected challenges surrounding their child’s feeding and growing in the pre-operative period and likely dietetic intervention strategies required to optimise their child’s growth trajectory. Feeding interventions do not end at time or surgery and postoperatively further intensive dietetic input is required for catch up growth and successful tube weaning. <h3>References</h3> Luca AC, Miron IC, Mîndru DE, Curpăn AȘ, Stan RC, Țarcă E, Luca FA, Pădureț AI. Optimal Nutrition Parameters for Neonates and Infants with Congenital Heart Disease. <i>Nutrients</i> 2022 Apr 17;<b>14</b>(8):1671. doi: 10.3390/nu14081671. PMID: 35458233; PMCID: PMC9029500. Ratanachu-Ek S, Pongdara A. Nutritional status of pediatric patients with congenital heart disease: pre- and post cardiac surgery. <i>J Med Assoc Thai.</i> 2011 Aug;<b>94</b>(Suppl 3):S133–7. PMID: 22043766. Xie O, Brizard CP, d’Udekem Y, Galati JC, Kelly A, Yong MS, <i>et al</i>. Outcomes of repair of complete atrioventricular septal defect in the current era. Eur J Cardiothorac Surg. 2014;<b>45</b>(4):610–7. St Louis JD, Jodhka U, Jacobs JP, He X, Hill KD, Pasquali SK, <i>et al</i>. Contemporary outcomes of complete atrioventricular septal defect repair: analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. <i>J Thorac Cardiovasc Surg.</i> 2014;<b>148</b>(6):2526–31." @default.
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• W4384566617 date "2023-06-19" @default.
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• W4384566617 title "826 Challenges in nutrition and growth supporting pre-operative infants undergoing surgical repair of ventricular septal defect and complete atrioventricular septal defect" @default.
• W4384566617 doi "https://doi.org/10.1136/archdischild-2023-rcpch.606" @default.
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