Functionally univentricular heart (including hypoplastic left heart syndrome, pulmonary atresia, tricuspid atresia, isomerism and more; see Chapters 68–73) Large ventricular septal defect (see Chapter 32) Atrioventricular septal defect with large ventricular component (see Chapter 31) Common arterial trunk (see Chapter 40) Large patent arterial duct (see Chapter 41) Atrial septal defect (see Chapter 29) Tetralogy of Fallot (see Chapter 35) Transposition of the great arteries (see Chapter 37) Totally anomalous pulmonary venous return (see Chapter 28) Pulmonary artery hypertension Aortic valve disease and (which is not amenable to surgery left ventricular outflow other than lung transplantation, see tract obstruction (see Chapter 75) Chapter 44) Anomalous left coronary artery Pulmonary stenosis (see from the pulmonary artery (see Chapter 42) Chapter 46) Coarctation of the aorta and interruption of the aortic arch (see Chapter 45) However, it is important to also consider that infants, children, and adolescents with CHD may not be immune to risk of overweight and obesity These children may have more sedentary lifestyles from restricted physical activity given perceived strain on the heart Families may also continue a highcalorie diet that was previously encouraged during the period of time prior to surgery or resolution of heart failure.20 Definition of Malnutrition In 2014 the Academy of Nutrition and Dietetics and the American Society of Parenteral and Enteral Nutrition published a consensus statement defining pediatric malnutrition as, “an imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein or micronutrients that may negatively affect growth, development and other relevant outcomes” (Table 86.2).21 Prior to this consensus statement, the prevalence of malnourished children in the United States was documented between 6% and 51% Factors contributing to this large variance in documented malnutrition included a lack of uniform definitions, lack of heterogeneous nutrition screening practices, and failure to prioritize nutrition as part of patient care.21 Table 86.2 Pediatric Malnutrition Classification (for Infants ≥1 Month of Age)21 Severe protein-calorie malnutrition ICD-10 (E43) Moderate malnutrition ICD-10 (E44.0) Mild malnutrition ICD-10 (E44.1) Single data point indications: ■ Weight for length or BMI for age −3 or greater z-score ■ Length/height-for-age −3 or greater z-score ■ Mid-upper arm circumference −3 or greater z-score Multiple data point indicators: ■