Tjoeng YL, Jenkins K, Deen JF, et al. - In this retrospective cohort study, researchers sought to explore the connection between race/ethnicity, the severity of illness, and mortality in congenital cardiac surgery, and to ascertain if severity of illness is a mechanism by which nonwhite patients experience increased surgical mortality. The sample consisted of children younger than age 18 years old undergoing cardiac surgery admitted to the intensive care unit (n = 40,545) between 2009 and 2016 from the Virtual Pediatric Systems (VPS, LLC, Los Angeles, Calif) database. Though African-American children undergoing cardiac surgery had higher postoperative mortality, this gap in survival appears to be mediated through disease severity. Preoperative and intraoperative factors can be causes of this difference in survival.