Background: To normally grow and develop, children with CONGENITAL HEART DISEASEs (CHD) in the hypermetabolic state need 50% more energy than healthy ones. Objectives: This study aimed to investigate the prevalence of malnutrition and its association with other factors among the nonsyndromic ACYANOTIC patients with CHD undergoing palliative or corrective surgery. Methods: A retrospective study of medical records of 812 children with ACYANOTIC CONGENITAL HEART DISEASE undergoing palliative or corrective surgery was performed from March 2011 to March 2017. Collected data consisted of the age at the time of the surgery, gender, weight at the time of the surgery, height at the time of the surgery, birth weight, length of ICU stay, and 1-year mortality. The WAZ, WLZ, LAZ, and BMI Z-scores were calculated based onWorld Health Organization (WHO) standards. We classified the Z-scores into 4 groups, including normal (Z-scores >-1), mild (-2 to >-1), moderate (-3 to >-2), and severe (<-3) malnutrition groups. Results: Total amount of 812 patients, 375 (46. 2%) were female and 437 (53. 8%) male, participated in this study. The average age, weight, and height at the time of the surgery were 23. 52 + 29. 38 months, 9. 086 + 6. 71 kilograms, and 76. 93 + 23. 37 centimeters, respectively. Moreover, 68. 7% and 66. 4% of the patients suffered from mild to severe forms of malnutrition based on WAZ and WLZ, respectively (P value < 0. 0001, 0. 025). There was no significant difference between males and females in WAZ, WLZ, LAZ and, BMIZ (P value: 0. 154, 0. 265, 0. 965, and 0. 667, respectively). Generally, in ACYANOTIC defects, we found that more severe malnutrition causes an increment in length of ICU stay (P value = 0. 001) and lesser birth weight has a significant relationship with the severity of growth failure in infancy or childhood (P value < 0. 0001). Conclusions: In our study, the high prevalence of the malnutrition and related complications during and after surgical repair shows the importance of nutritional support and interventions in patients with CHD.

Background: Children with CONGENITAL HEART DISEASE (CHD) who undergo cardiopulmonary bypass (CPB) are particularly at risk for neurodevelopmental impairment. Objectives: This study aims to assess the neurodevelopmental outcomes of Iranian children with ACYANOTIC CONGENITAL HEART DISEASE (aCHD) post-CPB, comparing them to a matched healthy control group. Methods: We performed a retrospective cohort study at Rajaie Cardiovascular Medical and Research Center, Tehran, Iran, from 2019 to 2022. Fifty children aged 4 to 69 months with ACYANOTIC and noncomplex CHD who required corrective open-HEART surgery and 50 healthy children as a control group were recruited for this study. Initial information about the child, including age, gender, parents' education level, parental consanguinity, economic status, and feeding type, was collected. The Modified Denver Developmental Screening Test II (DDST II) was used to assess developmental milestones in these children before and after surgery. The results of the tests were then compared to matched controls without CHD. Comparative analyses between the case and control groups were performed using chi-square tests and Mann-Whitney U tests. Pre- and post-operation comparisons within the case group were assessed using the Wilcoxon Signed Ranks Test. The normality of the data was tested using the Kolmogorov-Smirnov test. All statistical analyses were conducted using SPSS software version 16. Results: Significant differences were found between groups in maternal (P = 0.047) and paternal education levels (P = 0.015). Pre-operatively, children in the aCHD group had lower fine motor adaptive skills (P < 0.001) and total developmental scores (P = 0.022) than the control group, as measured by the modified Denver II test. Post-surgery, no significant improvements were observed in developmental domains or total scores (P = 0.994), suggesting that corrective surgery did not result in immediate neurodevelopmental benefits. Conclusions: While surgery did not lead to immediate improvements in developmental skills, parental education emerged as a significant contributor to better outcomes. These findings reinforce the need for multidimensional and interdisciplinary care approaches that address both medical and socio-environmental determinants of child development.

Background: End-tidal carbon dioxide (EtCO2) can approximate the arterial pressure of carbon dioxide (PaCO2) in children without underlying CONGENITAL HEART defects. However, EtCO2may underestimate PaCO2in these children, especially during repair procedures. The PaCO2to EtCO2difference (Δ PaCO2-EtCO2) may be significant in children with CONGENITAL HEART DISEASE (CHD) and can be notably influenced by surgical procedures. Postoperatively, the Δ PaCO2-EtCO2might not remain consistent,thus, arterial blood gas (ABG) analysis may need to be repeated regardless of capnography findings. This hypothesis was tested in our study on children with cyanotic and ACYANOTIC HEART defects undergoing corrective surgeries. Methods: In this cross-sectional study, hospital records of all children under 12 years of age with ASA II-III and cyanotic or ACYANOTIC HEART defects who were candidates for elective angiography were reviewed. EtCO2was measured by lateral aspiration capnography. Simultaneous measurements of EtCO2and PaCO2were collected before and after the intervention. Results: Significant changes were observed in serum HCO3concentration and the PaO2/FiO2ratio, both of which significantly decreased after the repair surgery. However, the change in Δ PaCO2-EtCO2remained insignificant postoperatively. In the cyanotic group, in addition to a significant reduction in serum HCO3value and an increase in the PaO2/FiO2ratio after the intervention, we found a significant decrease in Δ PaCO2-EtCO2. Conclusion: Arterial blood gas analysis during repair surgery should be repeated in the cyanotic CONGENITAL HEART defects group due to the intraoperative variability of Δ PaCO2-EtCO2, but not in the ACYANOTIC HEART defects group due to the stability of this difference. Therefore, EtCO2assessed by capnography can estimate PaCO2in children with ACYANOTIC HEART defects, but not in those with cyanotic HEART defects

Background: This study was performed to detect the severity of proteinuria in children with ACYANOTIC pulmonary hypertension.Methods: Twenty children suffering from pulmonary hypertension due to ACYANOTIC CONGENITAL HEART DISEASE evaluated for proteinuria. They were divided into two groups of equal less than two and more than two years old, because of the difference in proteinuria ratio in these two groups. Association of proteinuria with age, hematocrit, mean pulmonary arterial pressure and tricuspid regurgitation were evaluated.Results: although there was not any case of proteinuria in nephrotic range but significant proteinuria was observed in 2 out of 11 children aged below 2 year of age, and 3 out of 9 in children above 2 years old. However there was no relationship between age, mean pulmonary arterial pressure, hemoglobin, hematocrit, tricuspid regurgitation and proteinuria. There was not any relationship between proteinuria and the severity of pulmonary artery pressure, tricuspid regurgitation, age and hematocrit in this group of children.Conclusion: Significant proteinuria in children with ACYANOTIC CONGENITAL HEART DISEASE was present in 25% of cases (5 out of 20). Nephrotic syndrome is uncommom in children with ACYANOTIC pulmonary hypertension CONGENITAL HEART DISEASE.

Background: The rate of CONGENITAL HEART DISEASE is 0.8% in all live births. The majority of this, however, is ACYANOTIC CONGENITAL HEART DISEASE. The survival rate of children with cardiac DISEASE has increased with the developments provided in recent years and their lifetime is extended.Objectives: This study aims to evaluate neurodevelopment of children with uncomplicated ACYANOTIC CONGENITAL HEART DISEASE in preschool period and determine the factors affecting their neurodevelopmental process.Patients and Methods: 132 children with ACYANOTIC CONGENITAL HEART DISEASE aged 6 - 72 months were involved in the study. Mental development and intelligence levels of patients under 2 years old were assessed by using Bayley Development Scale-III, and Stanford Binet Intelligence test was employed for patients over 2 years old. Denver Developmental Screening Test II was applied to all patients for their personal-social, fine motor, gross motor and language development.Results: The average age of patients (67 girls, 65 boys) included in the study was 35.2 ± 19.6 months. It was determined that there were subnormal mental level in 13 (10%) patients and at least one specific developmental disorder in 33 (25%) patients. Bayley Mental Development Scale score of patients who had received incubator care in perinatal period was found significantly low (88 ± 4.2) compared to those with no incubator care (93.17 ± 8.5) (P=0.028). Low educational level of father was established to be linked with low mental development scores at the age of 2 and following that age (P<0.05). Iron deficiency anemia was discovered to be related to low psychometric test scores at every age (P<0.05).Conclusions: Neurodevelopmental problems in children with ACYANOTIC CONGENITAL HEART DISEASE were found higher compared to those in society. Mental development and intelligence levels of patients were determined to be closely associated with receiving incubator care, father’s educational level and iron deficiency anemia.

Background: CONGENITAL HEART DISEASE (CHD), a developmental abnormality of the HEART and vessels, is encountered in the pediatric age group frequently. Brachial artery flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT) are indicators of subclinical cardiovascular DISEASE and are used as surrogate measures of subclinical atherosclerosis. The present study aimed to compare CIMT and FMD between children with ACYANOTIC CONGENITAL HEART DISEASE (ACHD) and healthy controls. Methods: A case-control study on 50 children with ACHD and 43 healthy individuals was done in Isfahan, Iran, between 2021 and 2022. The case group was selected via non-random sampling, and healthy controls were recruited from the relatives of the patients. A checklist, including age, sex, body mass index, and blood pressure, was filled out for all the participants. Then, FMD and CIMT were measured with brachial and carotid artery ultrasonography. Results: Fifty children with ACHD and 43 healthy individuals (controls) under 18 years old participated in this study. Of these, 44 (47. 3%) were girls and 49 (52. 7%) were boys. The mean FMD was significantly higher in the ACHD group than in the control group (0. 084±0. 027 vs 0. 076±0. 042,P=0. 021,95% CI, 007 to 0. 122, ). CIMT was significantly higher in the ACHD group than in the control group (0. 39±0. 12 vs 0. 34±0. 1,P=0. 037,95% CI, 0. 009 to 0. 102, ). However, systolic and diastolic blood pressure did not show differences between the groups. Conclusion: Based on our results, CIMT and FMD assessment may help detect early changes in peripheral vessels associated with atherosclerosis in the future in ACHD. Further studies are needed to confirm our findings.

Background and Objective: Children with CONGENITAL HEART DISEASE (CHD) suffer from failure to thrive (FTT) after delivery and severe growth retardation in these patients may lead to FTT continuity even after corrective surgery. Therefore, early detection of FTT and early and appropriate intervention can produce improvement of these conditions. In this study we evaluated FTT and its patterns in children with CHD.Subjects and Methods: Two hundred and fifty children with CHD, who were admitted in Ahvaz Golestan hospital and were visited Mehr hospital for echocardiography out-patiently, were enrolled in our retrospective-descriptive study during 2007. Patients were divided into six age groups and evaluated for weight and stature. Data were analyzed by SPSS software and Pearson, Chi Square, Phi and Cramer testsnwere used.Results: Weight loss was more common among our patients, which was seen more frequently among girls than in boys. Weight loss and short stature were more common in patients with ACYANOTIC DISEASEs (the most common) with pulmonary hypertension (PHTN), while weight loss and short stature were more common in patients with cyanotic DISEASEs without PHTN. The majority of patients belonged to 1-5 month age group and in 6-11 month age group we had the majority of FTT forms.Conclusion: FTT was more common in patients who suffer from CHD with PHTN which was statistically significant (P<0.05). Large ventricular septal defect and patent ductus arteriosus were the first two DISEASEs. While in other studies large ventricular septal defect and tetralogy of Fallot were the most common. The results suggest that early surgical intervention and nutritional support among the 6-12 month age group can be fruitful in prevention of these complications.

Background: CONGENITAL HEART defect (CHD) is the most common CONGENITAL anomaly in infants and is known to be a leading cause of malnutrition. Objectives: This study aimed to provide insights into the prevalence of malnutrition in children with CHD in Iran. Methods: The study enrolled 515 under-five children with CHD. The diagnosis was based on the definitive result of cardiac catheterization report. They were divided into the subgroups of cyanotic with pulmonary hypertension (PH), ACYANOTIC with PH, cyanotic without PH, and ACYANOTIC without PH according to their diagnosis. The degree of growth failure and the severity of malnutrition were evaluated based on the WHO standards (z-score criteria) in three categories as mild (-1. 1 to-2. 0 SD), moderate (-2. 1 to-3. 0 SD), and severe ( 3 SD). Results: Amongthe studied groups, the most prevalentCHDswere ventricular septal defect (VSD; 42. 9%) and tetralogy of Fallot (TOF; 17. 3%). Severe malnutrition was significantly more prevalent in cyanotic patients with and without PH (n = 23; 63. 9% and n = 89; 51. 1%, respectively). Normal nutritional status was significantly more in ACYANOTIC patients without PH (P < 0. 001). Overall, malnutrition in this study was mild in 16. 3%, moderate in 24. 1%, and severe in 39. 8% of cases. Conclusions: The study showed that the prevalence of malnutrition in children withCHDaged under 5 years was noticeably high at this center in Iran. The administration of nutritional requirements such as low-volume and high-calorie diets should be considered for these vulnerable children.