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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Risk factors for morbidity in infants undergoing tetralogy of fallot repair

Alexander C Egbe1, Alexander J Mittnacht1, Khanh Nguyen1

  • 1Division of Pediatric Cardiology, Mount Sinai Hospital, One Gustave Levy Place, New York, NY.

Annals of Pediatric Cardiology
|April 5, 2014
PubMed

Insights

Primary repair of Tetralogy of Fallot (TOF) is safe with low mortality. Patient age and weight at surgery are key predictors of intensive care unit (ICU) morbidity following this procedure.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Neonatal Intensive Care

Background:

  • Tetralogy of Fallot (TOF) repair has low surgical mortality.
  • Significant postoperative morbidity can still occur in some patients.
  • Understanding predictors of morbidity is crucial for optimizing outcomes.

Purpose of the Study:

  • To review institutional experience with primary TOF repair.
  • To identify predictors of intensive care unit (ICU) morbidity after primary TOF repair.

Main Methods:

  • Retrospective study of patients undergoing primary TOF repair in infancy.
  • Analysis of preoperative, operative, and postoperative data.
  • Logistic regression used to identify predictors of prolonged ICU stay and mechanical ventilation.

Main Results:

  • Ninety-seven patients underwent primary repair with no early surgical mortality.
  • Median ICU stay was 6 days; median ventilation duration was 19 hours.
  • Patient age and weight independently predicted ICU length of stay; surgical era predicted ventilation duration.

Conclusions:

  • Primary TOF repair is a safe procedure with outcomes comparable to national standards.
  • Age and weight at surgery are significant predictors of postoperative morbidity.
  • Continued focus on patient-specific factors is important for minimizing ICU morbidity.
Abstract

Keywords:
Morbidityoutcomespediatrictetralogy of fallotventilation

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