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Objective To establish and validate a risk prediction model for severe pneumonia following cardiopulmonary bypass (CPB) in children with congenital heart disease. Methods All the children diagnosed with congenital heart disease and treated with CPB surgery in the Department of Thoracic Surgery, Children's hospital of Chongqing Medical University from October 2014 to December 2017 were assigned into the modeling group (n=1 415), while those treated from December 2017 to October 2018 were enrolled into the validation group (n=393). The independent risk factors for severe pneumonia after surgery were screened using univariate and multivariate Logistic regression analysis, and the corresponding nomogram prediction model was constructed according to the regression coefficients. The receiver operating characteristic (ROC) curve and calibration curve were used respectively to evaluate the discriminant validity and calibration of the prediction model. Results The following 5 indicators were revealed to be the independent risk factors for severe pneumonia after CPB surgery: age, weight, preoperative hospital stay, score of Risk Adjustment in Congenital Heart Surgery-1 (RACHS-1) and time of cardiopulmonary bypass. Based on them, an individualized prediction model was established. The area under the curve (AUC) of the prediction model was 0.943 (95%CI: 0.929-0.954) and 0.925 (95%CI: 0.894-0.949) for the modeling and validation groups, indicating good discriminant validity. The P value of the calibration test was 0.592 and 0.256 for the 2 groups. Conclusion Our established individualized prediction model can be well used to evaluate the risk of severe pneumonia in children with congenital heart disease after CPB.

Objective:  To summarize experience in the treatment of pentalogy of Cantrell (POC) in our hospital and explore the effect of artificial materials in repairing sternal defects.Materials and Methods:  A retrospective analysis was performed on treatment of five children with POC treated by using the Gore-Tex patch and titanium mesh in the Department of Cardio-Thoracic Surgery, Children's Hospital of Chongqing Medical University, from January 2010 to January 2019.Results:  The concurrent conditions included double outlet of right ventricle (n = 2), ventricular septal defect (VSD) and atrial septal defect (ASD) (n = 1), VSD and ASD and patent ductus arteriosus (n = 1), and VSD and left ventricular diverticulum (n = 1) in five cases with POC. Color Doppler echocardiography and computed tomography (CT) + three-dimensional (3D) reconstruction of the thorax and abdomen were performed preoperatively. The cardiac malformation was corrected according to color Doppler echocardiography, and a Gore-Tex patch was used to repair the pericardial defect. Titanium mesh was made according to CT 3D reconstruction with a 3D printing mold to repair sternal defects. All patients underwent a one-stage operation, all hearts were eventually repositioned, no deaths occurred after the operation, and follow-up was performed for 6 months to 2 years. The patients recovered well, and the exterior thorax was normal.Conclusion:  The diagnosis of POC is not difficult. The priority of surgical treatment for POC is to obtain satisfactory corrections of cardiac malformation. The repair of the pericardial defect with the Gore-Tex patch and the sternal defect with the titanium mesh can make the heart return to the mediastinum, reduce the pressure on the heart, reduce the surgical trauma, reduce the difficulty of repairing the sternal defect, and optimally restore the exterior thorax. [ABSTRACT FROM AUTHOR]

Purpose: The present study was undertaken to summarize our experience with the concurrent repair of pectus excavatum (PE) and congenital heart defects in young children over the past 15 years.Methods: A retrospective study was conducted that included patients who underwent combined repair of PE and a congenital heart defect in a large clinical center between 2002 and 2017. Intraoperative and postoperative patient characteristics, postoperative complications and surgical outcomes were recorded.Results: Twenty-one patients met the inclusion criteria. An open heart surgery and a modified sternal elevation with anterior sternal suspension were performed. No intraoperative complications occurred. Postoperatively, three patients developed pneumonia, two patients developed subcutaneous effusions, one patient sustained an asymptomatic pneumothorax, and one other patient had a transitory fever. In all cases, postoperative recovery was uneventful, and no perioperative mortality occurred. Bar removal was performed in 19 patients at an average of 2.55 years postoperatively: 18 of them achieved an excellent outcome, and 1 patient had a good final result.Conclusion: A combined procedure of modified sternal elevation and cardiac repair may be performed safely in young children. Early repair of PE is feasible and effective in these patients. [ABSTRACT FROM AUTHOR]