Objective: Carnitine is essential for long-chain fatty acid metabolism in order to produce biological energy via the mitochondria. Carnitine de ciency can result in cardiomyopathy, hypoglycemia, and other complications. is study aimed to determine how plasma carnitine levels changed before and a er open-heart surgery with cardiopulmonary bypass (CPB) in children with congenital heart disease. Methods: We measured free carnitine (C0) levels in the blood before and a er CPB, as well as on each

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... 7 days a er the procedure. Results: We treated 50 patients with average age of 35±49 months. We identi ed 19 patients with extracardiac complications, including eight with chromosomal disorder, three with suspected chromosomal disorder, four preterm births, two with digestive disorders, and two with other complications. C0 levels immediately before CPB were 55.8±24.4 nmol/mL, whereas immediately a er CPB were signi cantly lower [33.5±12.9 nmol/mL (the ratio of C0 level before and a er CPB were: 64±19%, p<0.01)]. Although there was no signi cant di erence in aortic clamp time, CPB time, or pre-operative blood data, the presence of extracardiac complications was signi cantly correlated to the C0 level just a er CPB (odds ratio, OR: 3.385, 95% con dence interval, CI: 1. 858-3.385, p<0.01). Conclusion: C0 dropped temporarily a er CPB and then returned three days later. Since the decrease in C0 a er CPB was linked to extracardiac complications in children with congenital heart disease, monitoring pre-and post-operative C0 concentration may be warranted in these patients.