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if the patient receives glucose iv in addition with proteins or proteins and lipids.

Clinical or subclinical identified on aEEG/EEG requiring medical treatment

from admission until surgery

High Flow nasal Oxygen, CPAP,NIV (non-invasiveventilation) (from admission until surgery)

cardiopulmonary resuscitation requiring chest compressions after discharge stage 1 until surgery stage 2

###RACHS - Risk adjustment for congenital heart surgery

Individual procedures by risk category

Risk category 1

• Atrial septal defect surgery (including atrial septal defect secundum, sinus venosus atrial septal defect, patent foramen ovale closure)
• Aortopexy
• Patent ductus arteriosus surgery at age >30 d
• Coarctation repair at age >30 d
• Partially anomalous pulmonary venous connection surgery

Risk category 2

• Aortic valvotomy or valvuloplasty at age >30 d
• Subaortic stenosis resection
• Pulmonary valvotomy or valvuloplasty
• Pulmonary valve replacement
• Right ventricular infundibulectomy
• Pulmonary outflow tract augmentation
• Repair of coronary artery fistula
• Atrial septal defect and ventricular septal defect repair
• Atrial septal defect primum repair
• Ventricular septal defect repair
• Ventricular septal defect closure and pulmonary valvotomy or infundibular resection
• Ventricular septal defect closure and pulmonary artery band removal
• Repair of unspecified septal defect
• Total repair of tetralogy of Fallot
• Repair of total anomalous pulmonary veins at age >30 d
• Glenn shunt
• Vascular ring surgery
• Repair of aorta-pulmonary window
• Coarctation repair at age ≤30 d
• Repair of pulmonary artery stenosis
• Transection of pulmonary artery
• Common atrium closure
• Left ventricular to right atrial shunt repair

Risk category 3

• Aortic valve replacement
• Ross procedure
• Left ventricular outflow tract patch
• Ventriculomyotomy
• Aortoplasty
• Mitral valvotomy or valvuloplasty
• Mitral valve replacement
• Valvectomy of tricuspid valve
• Tricuspid valvotomy or valvuloplasty
• Tricuspid valve replacement
• Tricuspid valve repositioning for Ebstein anomaly at age >30 d
• Repair of anomalous coronary artery without intrapulmonary tunnel
• Repair of anomalous coronary artery with intrapulmonary tunnel (Takeuchi)
• Closure of semilunar valve, aortic or pulmonary
• Right ventricular to pulmonary artery conduit
• Left ventricular to pulmonary artery conduit
• Repair of double-outlet right ventricle with or without repair of right ventricular obstruction
• Fontan procedure
• Repair of transitional or complete atrioventricular canal with or without valve replacement
• Pulmonary artery banding
• Repair of tetralogy of Fallot with pulmonary atresia
• Repair of cor triatriatum
• Systemic to pulmonary artery shunt
• Atrial switch operation
• Arterial switch operation
• Reimplantation of anomalous pulmonary artery
• Annuloplasty
• Repair of coarctation and ventricular septal defect closure
• Excision of intracardiac tumor

Risk category 4

• Aortic valvotomy or valvuloplasty at age ≤30 d
• Konno procedure
• Repair of complex anomaly (single ventricle) by ventricular septal defect enlargement
• Repair of total anomalous pulmonary veins at age ≤30 d
• Atrial septectomy
• Repair of transposition, ventricular septal defect, and subpulmonary stenosis (Rastelli)
• Atrial switch operation with ventricular septal defect closure
• Atrial switch operation with repair of subpulmonary stenosis
• Arterial switch operation with pulmonary artery band removal
• Arterial switch operation with ventricular septal defect closure
• Arterial switch operation with repair of subpulmonary stenosis
• Repair of truncus arteriosus
• Repair of hypoplastic or interrupted arch without ventricular septal defect closure
• Repair of hypoplastic or interrupted aortic arch with ventricular septal defect closure
• Transverse arch graft
• Unifocalization for tetralogy of Fallot and pulmonary atresia
• Double switch

Risk category 5

• Tricuspid valve repositioning for neonatal Ebstein anomaly at age ≤30 d
• Repair of truncus arteriosus and interrupted arch

Risk category 6

• Stage 1 repair of hypoplastic left heart syndrome (Norwood operation)
• Stage 1 repair of nonhypoplastic left heart syndrome conditions
• Damus-Kaye-Stansel procedure

main surgery stage 2

after main surgery stage 2

main intervention stage 2

main surgery stage 2

main surgery stage 2

main surgery stage 2

main surgery stage 2

main surgery stage 2

Any redo surgery after main surgery stage 2 until discharge stage 2

Any heart catheter intervention after main surgery stage 2 until discharge stage 2

cardiopulmonary resuscitation requiring chest compression, after main surgery stage 2 until discharge stage 2, cumulatively

cumulatively all incidents post op stage 2 including re do interventions

High Flow nasal Oxygen, CPAP, NIV (non invasive ventilation)

cumulatively all incidents post op stage 1 including re do interventions

confirmed infection = any evidence of infection requiring antibiotic therapy which is confirmed on microbiological culture (despite perioerative antibiotic prophylaxis)

wound infection = any evidence of infection requiring antibiotic therapy which is confirmed on a positive wound swap (despite perioperative prophylaxis)

respiratory = pleural effusions(drainage required), pneumothorax, haematothorax

cardiogenic NEC = Bell stage 2 or 3, infants with abdominal distension, blood in stool together with abdominal x-ray or ultrasound showing bowel oedema, pneumastosis or pneumoperitoneum

Stroke = clinical or MRI

LCO syndrome = combination of:

• mean blood pressure lower than 5th percentile of age-related normal values and/or increased inotropics/vasopressors required to achieve this blood pressure goal
• difference between the arterial oxygen saturation (SaO2) and central venous oxygen saturation (ScvO2) value of >35% or Scv=2<60% for non cyanotoc patients
• urine output <1ml/kg/hr
• peripheral temperature <32°C in the absence of the use of target temperature management
• serum lactate >2mmol/L

Any evidence of infection requiring antibiotic therapy which is confirmed on microbiological culture (despite perioperative anibiotic prophylaxis)

Any evidence of infection requiring antibiotic therapy which is confirmed on a wound swab (despite perioperative antibiotic prophylaxis)

Day of admission to your hospital until discharge after stage 2