Objective To analyze the incidence and influencing factors of postoperative malnutrition in children under 5 years old with congenital heart disease.Methods A retrospective analysis was conducted on the clinical data of 103 children under 5 years old with congenital heart disease who underwent open-heart rad-ical surgery at the hospital from August 2019 to December 2020.Age-specific height Z-scores(HAZ),age-spe-cific weight Z-scores(WAZ),and weight-for-height Z-scores(WHZ)were calculated.Malnutrition was de-fined as any Z-score<-2.Based on nutritional status,patients were divided into a malnutrition group and a normal nutrition group.Preoperative differences between the two groups in different age periods were com-pared,and nutritional status was followed up at 1,3,and 6 months postoperatively to analyze the influencing factors for postoperative malnutrition.Results Among 103 pediatric patients,42 had preoperative malnutri-tion,with a malnutrition incidence of 40.8%.The incidence of malnutrition decreased to 24.3%(25/103)six months after surgery.At one month postoperatively,HAZ,WAZ,and WHZ decreased compared with preoper-ative values across different age groups,while they increased at three and six months postoperatively;howev-er,only the WHZ in the toddler group showed a statistically significant difference compared to preoperative values(P<0.05).Multivariate logistic regression analysis indicated that preoperative malnutrition was a risk factor for malnutrition six months after surgery(P<0.05),whereas age stage had no effect on postoperative malnutrition at six months(P>0.05).Conclusion Children with congenital heart disease generally suffer from malnutrition before surgery,and early identification and intervention should be carried out to promote their growth and development.

Objective To evaluate the safety and mid- to long-term efficacy of surgical correction of isolated partial anomalous pulmonary venous connection (IPAPVC). Methods We retrospectively collected consecutive patients who were diagnosed with IPAPVC and underwent surgical correction at Fuwai Hospital of Chinese Academy of Medical Sciences and Fuwai Yunnan Cardiovascular Hospital from June 2009 to May 2019, summarized the basic preoperative and intraoperative data of patients, analyzed the postoperative and mid- to long-term follow-up results. Results A total of 54 patients were enrolled, including 29 males and 25 females, with an average age of 16.20±2.40 years, ranging from 1 month to 62 years. There were 28 (51.9%) patients with varying degrees of arrhythmia, 22 (40.7%) patients with cardiac insufficiency, and 39 (72.2%) patients with pulmonary hypertension. According to Bordy's typing, 14 (25.9%) patients were classified as type A, 23 (42.6%) type B, 4 (7.4%) type C, 5 (9.3%) type D and 8 (14.8%) mixed type. Transthoracic echocardiography was performed in the whole group of patients and the accuracy of staging diagnosis was 66.7% (36/54), and cardiac CT angiography (CTA) was performed in 37 patients and the accuracy of staging diagnosis was 94.6% (35/37). All surgical procedures were assisted with cardiopulmonary bypass, aortic cross-clamping time was 0-219 (67.02±5.23) min, cardiopulmonary bypass time was 40-261 (105.09±5.23) min, and there was no serious intraoperative complication. Postoperative tracheal intubation time was 0-230 (13.33±4.20) h, intensive care unit stay was 0-13 (1.89±0.28) days, postoperative hospital stay was 5-18 (7.20±0.38) days, and follow-up time was 16-140 (62.58±5.12) months. There were 2 (3.7%) all-cause postoperative deaths, including 1 in-hospital death and 1 death during the follow-up, and there was no intraoperative death. Among the survivors, there were 3 patients with surgery-related complications: 1 patient had atrial septal defect with the second surgical treatment, 1 early obstruction of the superior vena cava and 1 arrhythmia. Two patients had complications of IPAPVC (atrial fibrillation, collateral circulation) prior to surgery and underwent the second surgery with a poor prognosis, and 1 patient had preoperative cardiac insufficiency and atrial fibrillation, whose symptoms persisted for a long time during the follow-up. Conclusion IPAPVC accounts for a lower percentage of partial anomalous pulmonary venous connection, transthoracic echocardiography combined with CTA improves diagnostic accuracy, and IPAPVC should be treated with elective surgery after diagnosis. The surgical approach should be individualized with imaging features such as disease staging, number of drains and drainage location. Surgical treatment of IPAPVC is safe and effective, and regular follow-up is warranted.