The Effect of Transcatheter Ventricular Septal Defect Closure on Children’s Appetite, Hormones, and Growth

Objective: Children with congenital heart disease are at risk for malnutrition. The aim of this study is to investigate the changes in appetite, nutritional hormones, and anthropometric measurements of patients before and after the transcatheter closure of ventricular septal defect.
Materials and Methods: Twenty patients whose defect was closed percutaneously and 26 children as healthy control group were included in the study. The anthropometric evaluation, symptoms, and blood tests of patient group were enrolled at initial and follow-up (1st and 6th month visit).
Results: The median age of patient and control group was 27 and 29.5 months, respectively. Lack of appetite, inadequate weight gain, and fatigue were higher in the patient group at initial visit (p=0.027, p=0.029, and p=0.033, respectively). At 1st month after closure, the rate of decrease in lack of appetite, inadequate weight gain, and fatigue were statistically significant (p=0.016, p=0.031, and p=0.031, respectively). After closure, increasing body mass index, its z score, and mid-upper arm circumference were statistically significant at 1st month (p=0.008, p=0.018, and p=0.018, respectively). Insulin-like growth factor-1, insulin-like growth factor binding protein-3, and their z scores were increased compared to the initial values at 1st month (p=0.001, p=0.033, p=0.002, and p=0.048, respectively). Ghrelin levels showed a linear decrease; leptin levels showed a linear increase for 6 months.
Conclusion: Children with ventricular septal defect are under the risk of malnutrition. One of the goals of our treatment plan for these children should be the prevention of malnutrition; therefore, the timing of interventional therapy should be before malnutrition develops