Nutritional Progression of a Child With Hypoplastic Left Heart Syndrome During the Waiting Period for Heart Transplantation: A Case Report

Congenital heart diseases, including hypoplastic left heart syndrome (HLHS), frequently lead to malnutrition, which can result in worse outcomes in critical and perioperative situations. This study presents a case report based on clinical and nutritional data extracted from the electronic medical record of a 1-year and 10-month-old male infant diagnosed with HLHS, hospitalized in a tertiary cardiology hospital while awaiting a heart transplant. The length of hospitalization while waiting for the organ was approximately 13 months. Upon hospital admission, the child presented with severe malnutrition according to the World Health Organization Child Growth Standards. Thus, the decision was made to initiate enteral nutritional therapy in combination with an oral diet. Despite being complementary, the enteral nutritional intake ranged from 35 to 100 kcal/kg/d and 1.6 to 2.7 g of protein/kg/d. As a result, the child presented progressive weight gain, reaching normal values, as per World Health Organization growth standards, by the time of transplantation. Although limited, there was also an improvement in the child’s length-for-age metric. Physical examination also revealed other improvements, such as in hair pigmentation and recovery of body reserves. Most notably, the child had a satisfactory recovery following heart transplant surgery. Therefore, it appears that the nutritional therapy applied was effective in improving the nutritional status of a child with severe malnutrition, which may have contributed to the surgical success and good postoperative recovery. Children with HLHS may benefit from alternative feeding methods to achieve higher nutritional intake.