Cardiac surgery in malnourished infants and children In India

Cardiac surgery in malnourished infants and children

Advanced corrective and palliative cardiovascular surgical procedures have significantly reduced mortality related to congenital heart disease. However, in infants with congenital heart disease, inadequate nutrient intake, insufficient nutrient absorption, and increased energy needs limit the ability to grow and develop. Infants with congenital heart disease have a high prevalence of malnutrition. Nutrition provides an opportunity to optimize growth, development, and quality of life in an era of increased survival. Early intervention and identification of at-risk patients has the potential to decrease morbidity and mortality related to malnutrition in infants with congenital heart disease. Currently, a paucity of research prohibits practitioners from providing comprehensive evidence-based care and compromises the care of the growing population of patients with congenital heart disease who survive infancy. The purpose of this article is to examine existing evidence that could contribute to guidelines for improving outcomes and data gaps that can be filled. This article establishes a malnutrition prevention/growth promotion protocol using risk assessments, estimation of resting energy expenditure, calorie and protein administration recommendations, growth charts, discharge planning, and follow-up care.

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Pediatric Cardiac Surgery

At the Pediatric Heart Center at the Children's Hospital at Montefiore (CHAM), our internationally recognized physicians have been treating young patients with congenital and acquired heart defects for more than 50 years. We offer specialized surgical expertise for the entire spectrum of heart, chest and lung diseases for neonates through adolescents, from repairing minor holes in the heart to performing high-risk surgery such as heart transplantation. CHAM is also one of only a handful of hospitals across the nation offering hybrid surgery (minimally invasive surgery via catheter-based procedures).

Our pediatric heart surgeons, cardiologists, nurse practitioners, anesthesiologists, critical care intensivists and pediatricians collaborate in a multidisciplinary approach to customize the most effective, least invasive treatment plan for each patient. Multiple specialists from around the world and all phases of cardiac care evaluate every available option and procedure to choose the best one for each child. Our experts also participate in research to evaluate the latest treatments available and improve the standards of care.

Realizing that we are caring for not only the children but also their families, CHAM places great emphasis on family-centered care. Relatives and guardians receive exceptional education and communication about their loved one's heart condition and have access to important resources, such as our Child Life Program, social services staff and the Family Learning Place, to support them through hospitalization and follow-up care.

Unparalleled Surgical Expertise

The Pediatric Heart Center at CHAM has a reputation for being at the forefront of cutting-edge research and therapies. World-renowned surgeon Giles Peek, MD, ranked as one of Great Britain’s “Top 100 Children’s Doctors” is Co-Director of the Pediatric Heart Center and Chief of Pediatric Cardiothoracic Surgery. He has extensive experience in newborn and complex pediatric surgery and care, with a focus on fetal cardiology and significant Extracorporeal Membrane Oxygenation (ECMO) expertise.

Robert H. Pass, MD, Director, Pediatric Interventional Cardiology, is a highly respected expert in the use of catheter-based therapies to treat congenital heart disease (CHD). His skills in stent placement, atrial septal defect (ASD) and patent ductus arteriosis (PDA) closure, and the hybrid approach to CHD have helped children with CHD receive the best in interventional and surgical care.

Our team includes three highly specialized and dedicated pediatric nurse practitioners who tend to our patients and their relatives before, during and after surgery. Martine Bouzi, NP, Melissa Narvaez, NP, and Kristine Cook, NP, are available to answer questions from patients and families.

Specialized Procedures for All Phases and Types of Children's Heart Diseases

Our patients benefit from our decade in the field and highly specialized expertise for even the most complex conditions, state-of-the-art technology (e.g., ventricular assist devices and transplantation) and multidisciplinary approach. CHAM's team treats the full range of pediatric heart defects (valve disease, atrial and ventricular septal defects, hypoplastic left heart syndrome, Marfan syndrome, Tetralogy of Fallot and any opening or obstruction in the heart) and offers an extensive array of advanced procedures. Some of these include: