Pediatric corrective heart surgery requires long - term follow - up care by a pediatric cardiologists, nurse specialists as well as routine follow up by a family, especially with children who have undergone repair at a very early age.(38).The present study was applied Cincinnati children's Down syndrome program with Congenital Heart Defects the from table (1 - 16) demonstrated that there were an improvement of the patient's conditions,also the attendance of parents during Cardiac Rehabilitation program and Self-Care program for their children lets the children to feel safe and it consider as an excellent cooperation between the health team and the child's family as well as it reduce the parent's anxiety ,and Table (16) clarify these facts ,while the health team tends to do very well after open-heart surgery, the risk of untoward complications is relative to the magnitude of the operative procedure. This, in turn, relates to the complexity of the underlying congenital heart disease; decreased cardiac output related to hypovolemia associated with persistent bleeding post-operatively; excessive loss of fluids resulting from nasogastric tube drainage, vomiting, diuretic and decreased fluid intake; also as a result of hypotension associated with hypovolemia as a result of rapid body warming following surgery, decreased mobility (39). Maintain adequate cardiac output: place patient in a semi-to high Fowler`s position, instruct patient to avoid activities that create a Valsalva response, oxygen therapy, small and frequent nasogastric meals perform actions to prevent hypotension by