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Safety and Effectiveness of Radiologic Percutaneous Gastrostomy and Gastro jejunostomy in Children with Cardiac Disease

¹ Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, Canada M5G 1X8.
² Department of Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.
³ Department of Statistics–Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
⁴ Ellesmere X-ray Associates, Scarborough, ON, Canada.

OBJECTIVE. The purpose of our study was to evaluate the safety and effectiveness of radiologic percutaneous gastrostomy and gastrojejunostomy for providing nutritional support in children with cardiac disease.

MATERIALS AND METHODS. Retrospective chart review of 58 children with cardiac disease who underwent radiologic percutaneous gastrostomy from November 2001 to June 2005 was conducted. Patient data were collected until January 2007. The patients' weights were collected at the time of insertion and 6, 12, 18, and 24 months after insertion, and weight-for-age z-scores were calculated.

RESULTS. The mean weight-for-age z-score increased from –2.79 at the time of radiologic percutaneous gastrostomy insertion to –2.33 (p = 0.05) at 6 months after insertion, –1.89 (p = 0.001) at 12 months, –1.65 (p = 0.0002) at 18 months, and –1.40 (p = 0.0004) at 24 months. Repeated measures regression analysis showed a significant increase in weight-for-age z-score over time (p < 0.0001), with an estimated mean increase in weight-for-age z-score of 0.055 per month. No mortality was associated with the insertion or usage of radiologic percutaneous gastrostomy. Major complications included intestinal perforation (3.4%) and aspiration pneumonia (12.1%).

CONCLUSION. Radiologic percutaneous gastrostomy is a safe method for providing long-term nutritional support in children with cardiac disease and is effective for improving growth and nutrition in this group of patients.

Keywords: cardiac disease • congenital heart disease • gastrojejunostomy • gastrostomy • interventional radiology • nutrition

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