PROGRESS IN PEDIATRIC CARDIOLOGY最新文献

{"title":"Prognostic implications of fragmented QRS in pediatric heart diseases: A systematic review","authors":"Mohammadreza Naghibi Sistani,&nbsp;Ahmad Farajzadeh,&nbsp;Feisal Rahimpour","doi":"10.1016/j.ppedcard.2026.101959","DOIUrl":"10.1016/j.ppedcard.2026.101959","url":null,"abstract":"<div><h3>Background</h3><div>Fragmented QRS (fQRS) is a myocardial conduction abnormality reflecting fibrosis and has been investigated in adults as a predictor of adverse cardiovascular outcomes. However, its prognostic importance in children remains unclear.</div></div><div><h3>Aim of review</h3><div>This systematic review aimed to evaluate the association between fQRS and adverse outcomes in pediatric patients with heart diseases.</div></div><div><h3>Key scientific concepts of review</h3><div>A search of PubMed, Web of Science, EMBASE, Scopus, and the Cochrane Library was performed up to June 2024, using predefined keywords. Included studies were observational and enrolled participants younger than 20 years with isolated cardiac disease, assessing fQRS on electrocardiography in relation to outcomes including ventricular dysfunction, arrhythmias, or major adverse cardiovascular events (MACE). The risk of bias in the included studies was assessed using the Newcastle–Ottawa checklists, and the study was designed based on the PRISMA guidelines. (PROSPERO: CRD420250656353).</div><div>From 5694 studies, nine comprising 625 pediatric patients were included. Populations consisted of repaired Tetralogy of Fallot (rTOF), dilated cardiomyopathy with or without left ventricular noncompaction, and congenitally corrected transposition of the great arteries. In rTOF, fQRS was consistently associated with right ventricular structural and functional impairment, including reduced RVEF and increased RVEDVi and RVESVi, whereas correlations with left ventricular parameters were inconsistent in pediatric patients with cardiomyopathy. Evidence for arrhythmias was variable, though two studies identified links between fQRS and ventricular arrhythmias in patients with left ventricular noncompaction. Available evidence also suggested a possible association between fQRS and MACE in pediatric DCM, although methodological heterogeneity and the limited number of studies warrant cautious interpretation.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101959"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148641469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The missing left main: A clinical lesson in detecting ALCAPA","authors":"Muhtasim Rahman Zahin,&nbsp;Julia Sun,&nbsp;Nigel Sutherland,&nbsp;Chiew Wong,&nbsp;Gautam Vaddadi","doi":"10.1016/j.ppedcard.2026.101938","DOIUrl":"10.1016/j.ppedcard.2026.101938","url":null,"abstract":"<div><div>Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a very rare congenital defect with a high mortality rate (90%) that presents mostly during infancy with ischemia, arrhythmia, and ventricular dysfunction. However, extensive collateral circulation from the right coronary artery may lead to survival into adulthood (Blickenstaff et al., 2023).</div><div>We report a case of an adult survivor of ALCAPA with a delay in this patient's diagnosis due to suboptimal imaging acquisition on initial Compute Tomography (CT) Coronary Angiogram (CA). We also focus on the concept of diagnostic error, a relevant but under-recognized area of medicine.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101938"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major aortopulmonary collateral artery arising from the celiac trunk in an acyanotic neonate case report","authors":"Brody Mann,&nbsp;Jon Donnelly,&nbsp;Jennifer Talmadge,&nbsp;Salim Gnabode,&nbsp;Alan Riley","doi":"10.1016/j.ppedcard.2026.101949","DOIUrl":"10.1016/j.ppedcard.2026.101949","url":null,"abstract":"<div><div>Major aortopulmonary collateral arteries (MAPCAs) are commonly seen in cyanotic congenital heart disease as anomalous systemic vessels supplying pulmonary parenchyma. We describe a neonate with Trisomy 21 and a large inlet ventricular septal defect (VSD) who developed early tachypnea and heart failure. Airway evaluation and contrast-enhanced CT revealed an unsuspected large MAPCA arising from the celiac trunk to the right lower lobe that was not seen using standardized echocardiographic technique. Cardiac catheterization confirmed a hemodynamically significant dual-supplying MAPCA, prompting coil embolization to reduce pulmonary overcirculation and simplify surgical repair. This case highlights the potential value of cross-sectional angiography for identifying occult MAPCAs in acyanotic infants with congenital heart disease and refractory heart failure symptoms.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101949"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of handgrip strength for identifying cardiometabolic risk in children and adolescents: a scoping review","authors":"José Julián Bernal-Sánchez,&nbsp;Angie Daniela Manrique-Alzate,&nbsp;Jennifer Ampudia-Moreno,&nbsp;Sara Valentina Freire-Mena,&nbsp;Diana Carolina Urrea-Arango,&nbsp;Jennifer Jaramillo-Losada,&nbsp;Diana Yazmín Perafan-Gonzalez","doi":"10.1016/j.ppedcard.2026.101950","DOIUrl":"10.1016/j.ppedcard.2026.101950","url":null,"abstract":"<div><h3>Background</h3><div>Cardiometabolic risk in children and adolescents is an increasing global concern, driven by rising rates of obesity, physical inactivity, and unhealthy lifestyle behaviors. Early alterations such as insulin resistance, dyslipidemia, elevated blood pressure, and low-grade inflammation may develop during childhood and persist into adulthood, contributing to premature cardiovascular disease. Identifying simple, accessible, and reliable markers for early risk detection is therefore a priority in pediatric clinical practice and prevention strategies, particularly in diverse healthcare settings.</div></div><div><h3>Aim of review</h3><div>To synthesize the available evidence on the clinical utility of handgrip strength (HGS) in relation to cardiometabolic risk in children and adolescents.</div></div><div><h3>Key scientific concepts of review</h3><div>Available evidence indicates that lower HGS is observed in relation to less favorable cardiometabolic profiles across different pediatric populations, including higher adiposity, elevated blood pressure, unfavorable lipid profiles, insulin resistance, and inflammatory markers. Relative HGS, adjusted for body size, is frequently reported as a more informative measure than absolute strength, although different normalization strategies have been used. Considerable heterogeneity is evident in measurement protocols, dynamometry procedures, normalization methods, and population characteristics, which limits comparability across studies and the interpretation of findings. The relationship between HGS and cardiometabolic variables appears to be influenced by body composition, particularly the balance between lean and fat mass, and may vary according to population characteristics. Most of the available evidence is based on observational designs, predominantly cross-sectional, which limits causal inference. Although HGS represents a simple, low-cost, and non-invasive measure, the absence of standardized protocols, normative values, and validated cut-off points currently limits its use in routine clinical practice. Overall, HGS may represent a potential complementary measure for early identification and risk stratification, although further standardization and longitudinal studies are needed to clarify its clinical utility.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101950"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of children with congenital heart defects and their caregivers in three U.S. sites: the Congenital Heart Survey To Recognize Outcomes Needs and well-beinG of KIDS (CHSTRONG KIDS)","authors":"Karrie F. Downing,&nbsp;Shannon E. Moss,&nbsp;Sook Ja Cho,&nbsp;Martha M. Werler,&nbsp;Heather Pint,&nbsp;Eric Rubenstein,&nbsp;Vanessa I. Avemil,&nbsp;Ruby Barnard-Mayers,&nbsp;Julianna F. Dick,&nbsp;Karmen Dippmann,&nbsp;Barbara K. Frohnert,&nbsp;Rebecca F. Liberman,&nbsp;Alexis A. Miket,&nbsp;Eirini Nestoridi,&nbsp;Matthew E. Oster,&nbsp;Rebecca Thom,&nbsp;Marissa Tuler,&nbsp;Mahsa M. Yazdy,&nbsp;Yuan Zhang,&nbsp;Emily O. Olsen","doi":"10.1016/j.ppedcard.2026.101956","DOIUrl":"10.1016/j.ppedcard.2026.101956","url":null,"abstract":"<div><h3>Background</h3><div>Many US children have congenital heart defects (CHD), yet data on their long-term outcomes have limitations. The Congenital Heart Survey To Recognize Outcomes, Needs, and well-beinG of KIDS (CHSTRONG KIDS) addresses these gaps by surveying caregivers of children with CHD identified through birth defect surveillance systems [BDSS].</div></div><div><h3>Objectives</h3><div>To describe the CHSTRONG KIDS project design, characteristics of the eligible population, and the percentage not up-to-date on recommended cardiology care.</div></div><div><h3>Methods</h3><div>Children born 2006–2021 with CHD were identified using active, population-based BDSS in Atlanta, Georgia, Massachusetts, and Minnesota and linked to vital records. Caregivers of eligible (living) children with CHD were invited to complete surveys in 2024–2025. Characteristics were compared by site and response status using χ² tests. We also estimated percentages of children in CHSTRONG KIDS who had not seen a cardiologist within the guideline-recommended timeframe for their specific defects.</div></div><div><h3>Results</h3><div>Among 7239 identified children with CHD, 6240 were eligible for survey recruitment. Of those,1841 (30%) had caregiver-reported survey data. Several characteristics, including CHD severity, birth year, and Trisomy 21 diagnosis, varied by site (<em>p</em> &lt; 0.05). Survey response rates differed by site, CHD severity, maternal race, maternal education, and rurality (p &lt; 0.05), prompting development of post-stratification weights. A weighted 21.6% were not up-to-date on their cardiology care.</div></div><div><h3>Conclusion</h3><div>With data on &gt;7200 CHD cases and &gt;1800 caregiver-reported surveys, CHSTRONG KIDS provides a population-based view of long-term outcomes among children with CHD. Notably, one in five were not up-to-date on their cardiology care and therefore may not be represented in clinical cohorts.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101956"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148540539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are children with transposition of the great arteries at greater risk of thrombosis?","authors":"Nasser Kreary,&nbsp;Shawana Shaikh,&nbsp;Mohamed Al Nasef,&nbsp;Tareq Alanezi,&nbsp;Bader Allahyani,&nbsp;Amr Arafat,&nbsp;Azah Alzahrani,&nbsp;Ahmed Elhassan,&nbsp;Abdullah Alwadai","doi":"10.1016/j.ppedcard.2026.101937","DOIUrl":"10.1016/j.ppedcard.2026.101937","url":null,"abstract":"<div><h3>Background</h3><div>Thrombosis is a critical complication in children with congenital heart disease (CHD), contributing to significant perioperative morbidity and mortality. While the risk is recognized across CHD, the specific incidence and predictors of thrombosis in patients with transposition of the great arteries (TGA) remain poorly defined.</div></div><div><h3>Objectives</h3><div>This study aimed to determine the incidence of perioperative thrombosis in children undergoing corrective cardiac surgery and to compare the risk between patients with and without TGA.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 217 consecutive children who underwent corrective open-heart surgery for biventricular repair using cardiopulmonary bypass (CPB) between January 2016 and December 2022. The cohort was divided into patients with TGA (<em>n</em> = 111, 51%) and a comparative group with other forms of CHD (non-TGA, <em>n</em> = 106, 49%). The primary outcome was the incidence of clinically diagnosed thrombosis in the perioperative period.</div></div><div><h3>Results</h3><div>The overall incidence of thrombosis was 10% (22/217). The incidence was significantly higher in the TGA group at 16.2% (18/111) compared to 3.7% (4/106) in the non-TGA group (<em>p</em> = 0.003; relative risk = 4.3). Multivariable analysis identified TGA as a strong independent predictor of thrombosis (Odds Ratio: 11.71; <em>p</em> &lt; 0.001). Thrombosis occurred in 14/72 (19%) patients with TGA and an intact interventricular septum compared to 4/39 (10%) TGA patients with a ventricular septal defect. Sixty-five (58%) patients with TGA underwent balloon atrial septostomy; 18 (27%) developed thrombosis, whereas none of those who did not undergo BAS developed thrombosis (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Children with TGA have a substantially increased risk of perioperative thrombosis compared to children with other forms of congenital heart disease undergoing biventricular repair. Balloon atrial septostomy could be a major contributing factor to this elevated risk, although it also reflects severe preoperative illness that independently predisposes to thrombosis. These findings highlight the need for heightened vigilance and suggest that prophylactic strategies may be warranted in this vulnerable population, particularly in the context of BAS.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101937"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity-related cardiometabolic correlates of adolescent exposure to phthalates: Another aspect of a major pediatric epidemic hiding in plain sight","authors":"Michael Weitzman","doi":"10.1016/j.ppedcard.2026.101958","DOIUrl":"10.1016/j.ppedcard.2026.101958","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101958"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148540540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When free rolls aren't free: Incentive asymmetry and the hidden costs of transparency in pediatric cardiac care","authors":"Mohamed Abozaid,&nbsp;Murad Almasri,&nbsp;Joshua Daily","doi":"10.1016/j.ppedcard.2026.101946","DOIUrl":"10.1016/j.ppedcard.2026.101946","url":null,"abstract":"<div><div>In behavioral economics, a “free roll” describes a decision with potential gain and no meaningful downside risk. In rare, extreme-risk congenital cardiac cases, families may perceive intervention as a clinical analog of a free roll because mortality is certain without treatment, while survival remains possible with it. For clinicians, however, attempting the same intervention is not without downside: publicly visible outcome reporting assigns procedural deaths to surgical programs, creating professional and institutional consequences even in near-certain-fatality cases. Differences in reporting visibility across procedural domains create asymmetric downside exposure: high-risk interventions may carry institutional penalty in the surgical domain but function as effective free rolls in the catheterization domain. These structural pressures interact with predictable features of human judgment in both families and clinicians, amplifying their influence at the margins. This Perspective examines how reporting architecture shapes decision environments in near-certain-fatality scenarios and proposes targeted structural refinements, such as compassionate-use designations, contextualized reporting, and parallel learning registries, to preserve transparency while supporting patient-centered care for the sickest children.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101946"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic and geographic factors are associated with lower prenatal diagnosis rates of congenital heart disease","authors":"Benjamin Ittleman,&nbsp;Waylon J. Howard,&nbsp;Kathryn Virk,&nbsp;Nicholas K. Brown,&nbsp;Elizabeth Caris,&nbsp;Jeffrey Conwell,&nbsp;Lindsay A. Edwards,&nbsp;Mark Lewin,&nbsp;Nelangi M. Pinto,&nbsp;Matthew Studer,&nbsp;Luciana Young,&nbsp;Bhawna Arya","doi":"10.1016/j.ppedcard.2026.101948","DOIUrl":"10.1016/j.ppedcard.2026.101948","url":null,"abstract":"<div><h3>Background</h3><div>Prenatal diagnosis (PND) of congenital heart disease (CHD) optimizes perinatal management and improves preoperative status; with survival benefit demonstrated for select lesions. Despite advances in fetal imaging, PND rates remain variable, with persistent disparities linked to socioeconomic, demographic, and geographic factors. However, these variables and their combined impact within a regional care network encompassing a large area of the Northwest United States have not been previously examined.</div></div><div><h3>Objective</h3><div>Evaluate the association between socioeconomic and geographic factors—including race, ethnicity, Area Deprivation Index (ADI), and distance from a regional surgical center—and PND of significant CHD, and to compare postoperative outcomes by PND status.</div></div><div><h3>Methods</h3><div>This single-center cross-sectional study included all patients with significant CHD requiring surgery within the first year of life and diagnosed between 2014 and 2022 at a regional referral center in the Northwestern United States. Socioeconomic and geographic variables were extracted, including race, ethnicity, insurance status, and address, which were used to determine state and national ADI rankings and distance to the surgical center. Postoperative outcomes were obtained. Group comparisons used nonparametric and categorical analyses.</div></div><div><h3>Results</h3><div>Among 929 patients, 736 (79.2%) were diagnosed prenatally. Higher state-level ADI (<em>p</em> &lt; 0.001), non-White race (<em>p</em> = 0.003), Hispanic ethnicity (<em>p</em> = 0.03), and greater distance from the surgical center (<em>p</em> = 0.009) were independently associated with lower PND rates. Prenatally diagnosed patients had higher 30-day mortality (<em>p</em> = 0.003) and reintubation rates (<em>p</em> &lt; 0.001), reflecting increased disease severity.</div></div><div><h3>Conclusion</h3><div>Socioeconomic disadvantage, non-White race, Hispanic ethnicity, and greater geographic distance were associated with lower PND rates. Mapping PND alongside regional deprivation indices may help identify underserved areas and guide targeted interventions.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101948"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are weight, age and faltering growth at surgery associated with surgical course and long-term weight recovery following ventricular septal defect closure?","authors":"Sharon Brosilow,&nbsp;Chen Wolfgor,&nbsp;Yishay Salem,&nbsp;David Mishaly,&nbsp;Zvi Adler,&nbsp;Salvatore Campisi-Pinto,&nbsp;Asaad Khoury","doi":"10.1016/j.ppedcard.2026.101953","DOIUrl":"10.1016/j.ppedcard.2026.101953","url":null,"abstract":"<div><h3>Background</h3><div>Earlier repair of large ventricular septal defects (VSDs) is more common; however, optimal timing and the extent to which age and anthropometric measurements predict morbidity and weight recovery remain uncertain.</div></div><div><h3>Objective</h3><div>To assess whether age, weight, weight-for-age percentile (WAP), and duration of preoperative growth impairment are associated with perioperative outcomes and postoperative weight recovery after VSD closure.</div></div><div><h3>Methods</h3><div>Retrospective review of infants undergoing surgical repair of large VSDs between 2017 and 2022. Anthropometric measurements at surgery were analyzed in relation to perioperative variables and postoperative growth outcomes.</div></div><div><h3>Results</h3><div>Eighty-seven infants were included (Average weight at surgery 4.93 kg ±1.35, median age at surgery 14 weeks [11.1, 24.5]). Major complication occurred in 4 infants. Infants weighing &lt;4 kg at surgery had longer pediatric intensive care unit (PICU) stay than those weighing ≥4 kg (6 [4, 8] vs 4 [3, 5] days, <em>p</em> = 0.03). Similarly, infants operated at age &lt; 9 weeks had longer PICU stay (6 [4, 7.2] vs 4 [3, 5], p = 0.03) and longer postoperative hospitalization than those operated at age ≥ 9 weeks (10 [7, 16.2] vs 6 [6, 8], <em>p</em> = 0.02). On multivariable analysis, younger age and lower weight were independently associated with prolonged postoperative hospitalization, while younger age was associated with longer cardiopulmonary bypass time. Infants with WAP below the 3rd percentile at surgery required longer to stabilize on a weight trajectory (44 [23.9, 57.2] vs 21 [8.7, 36.9] weeks, <em>p</em> = 0.02) and subsequently tracked along lower weight-for-age percentiles (25.5 [14.7, 55] vs 72 [53, 78.9], <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Lower operative weight and younger age were associated with longer PICU stay and postoperative hospitalization, while significant preoperative growth faltering was linked to delayed postoperative weight stabilization and lower subsequent weight-for-age percentiles.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"83 ","pages":"Article 101953"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148641332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}