Background and Objective: Vitamin D deficiency has been implicated in a wide range of conditions such as infectious and autoimmune diseases, cardiovascular and cerebrovascular events, and various malignancies to unfavorable birth outcomes. We studied vitamin D status in a group of neonates with congenital heart disease (CHD) and its relationship with the outcome of heart surgery.
Materials and Methods: Total vitamin D levels in plasma were measured before and 24 hours after the operation in 45 neonates with CHD undergoing heart surgery and in 77 hospitalized neonates without a history of CHD as controls, at Children’s Medical Center between March and September 2018.
Results: Preoperative vitamin D levels in patients with CHD were not significantly different from the control group (42.4 +/- 18.0 versus 46.9 +/- 27.7 nmol/L, P=0.640). Patients’ vitamin D levels decreased postoperatively (42.4 +/- 18.0 versus 36.2 +/- 14.5 nmol/L, P=0.013). This decline was significant in the cyanotic and open-heart surgery groups, but not in non-cyanotic or closed-heart surgery groups. In 41 (91.1%) patients, the outcome was successful discharge from the hospital, in 3 (6.7%), the outcome was demise, and in one, it was not determined due to early discharge. Preoperative and postoperative vitamin D levels did not show any relationship with the outcome. However, logistic regression analysis revealed a significant relationship between the amount of postoperative decline in vitamin D levels and the outcome of death (OR=1.261, 95% CI=1.026-1.551, P=0.028).
Conclusion: Results corroborates previous findings and suggests the amount of postoperative decline in vitamin D levels as a predictor of the outcome of heart surgery in CHD.

Partial muscular inter-ventricular septal defect (VSD) or Pacman heart is a rare congenital or occasionally acquired anomaly. Concurrent Pacman heart and Shone's complex are extremely rare and have never been reported until now. We described a 37-year-old male patient with congenital Pacman heart, flail mitral valve (FMV), and a history of multiple congenital anomalies, including subvalvular aortic stenosis, bicuspid aortic valve (AV), and coarctation of the aorta compatible with the incomplete form of Shone's complex. Cardiac surgery was not necessary to perform for this anomaly due to the absence of a left-to-right shunt through this partial defect.