U. Dyamenahalli et al., Influence of perioperative factors on outcomes in children younger than 18months after repair of tetralogy of Fallot, ANN THORAC, 69(4), 2000, pp. 1236-1242
Citations number
25
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. There has been a trend toward advocating earlier repair of tetr
alogy of Fallot and avoiding palliative procedures. The impact of this tren
d on perioperative outcomes has not been adequately documented.
Methods. Data from consecutive patients undergoing repair of tetralogy of F
allot at less than 18 months of age frost May 1987 to September 1994 were r
eviewed. Independent factors associated with duration of stay in the intens
ive care unit were sought.
Results. Repair was performed in 89 infants at a median age of 13 months (r
ange, 15 days to 18 months). A systemic-pulmonary artery shunt was present
in 24% of patients. Mean duration of cardiopulmonary bypass was 119 +/- 37
minutes; 63% of patients received a transannular patch. There were six deat
hs (7%), all occurring less than 48 hours after repair. The median duration
of stay in the intensive care unit was 5 days (range, 1 day to 8 months).
Significant independent factors associated with increasing length of intens
ive care unit stay included younger age at repair, previous shunt, malforma
tion syndrome, increased total dose and number of inotropic agents used, an
d respiratory complications. Hemodynamic variables serially recorded in the
first 48 hours after repair were independently associated with death or pr
olonged (>7 days) duration of stay.
Conclusions. Although outcomes after repair of tetralogy of Fallot in infan
ts are good, both younger age at repair and previous palliative procedures
were associated with longer duration of stay in the intensive care unit. (C
) 2000 by The Society of Thoracic Surgeons.