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DOI: 10.1055/s-0045-1804100
Key Factors Influencing Outcomes and ICU Stay After Tetralogy of Fallot Repair
Authors
Background: Primary repair of tetralogy of Fallot (TOF) typically has low mortality, but postoperative complications persist. This review examines predictors of prolonged ICU stay.
Methods: We reviewed all TOF infants who underwent primary surgery from 2003 to 2021 at our institution, focusing on transannular or infundibular patch procedures. Prolonged ICU stay was defined as a length of stay (LOS) of ≥4 days.
Results: 197 patients underwent primary surgical repair. Mean age was 4.8 months (95% CI: 1–11 months) and mean weight was 6.02 kg (95% CI: 3.3–8.6 kg). No deaths occurred within 30 postoperative days, but 10 patients needed reintervention in this period. Mean ICU LOS was 5.5 days (95% CI: 2–16 days). Mean intubation time was 43 hours (95% CI: 9–116 hours). 54% of patients had a prolonged ICU stay. Patient’s age and weight did not significantly affect ICU LOS. The surgical technique influenced ICU LOS: ICU LOS in patients with transannular patch was 3 days longer (p < 0.01) than in patients following infundibular patch. Arrhythmia occurred in 14% of patients. The incidence of arrhythmia was not influenced by the surgical technique (P = 0.06), but its incidence increased LOS by 5 days. Pleural effusion occurred in 19% of patients; 90% of these patients needed an additional pleural drain. Pleural effusion occurred more frequently with the transannular patch procedure (p = 0.048), and its incidence increased LOS by 6 days.
|
Short (<4 d; 46%) |
Prolonged (≥4 d; 54%) |
P-value |
|
|---|---|---|---|
|
Age (months, mean) |
5.1 (95% CI: 1.3–8.8) |
4.6 (95% CI: 2.0–7.1) |
0.27 |
|
Weight (kg, mean) |
6.2 (95% CI: 4.7–7.6) |
5.87 (95% CI: 4.7–7.1) |
0.08 |
|
Surgical technique • Transannular • Infundibular |
27 patients64 patients |
36 patients (mean 10.7 d)70 patients (mean 7.2 d) |
<0.01 |
|
Arrythmia |
0 patients |
27 patients |
|
|
Pleural effusion |
0 patients |
37 patients |
Conclusion: The mean ICU LOS for patients undergoing TOF repair was 5.5 days. Prolonged LOS (≥4 d) was influenced by the intervention with transannular patch, and the occurrence of arrythmia or pleural effusion.
No conflict of interest has been declared by the author(s).
Publication History
Article published online:
11 February 2025
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