Roxanne E Kirsch1, Andrew C Glatz2, J William Gaynor3, Susan C Nicolson4, Thomas L Spray3, Gil Wernovsky5, Geoffrey L Bird5. 1. Division of Critical Care, Department of Anesthesiology and Critical Care Medicine, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa. Electronic address: kirschr@email.chop.edu. 2. Division of Cardiology, Department of Pediatrics, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa. 3. Division of Cardiothoracic Surgery, Department of Pediatric Surgery, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa. 4. Division of Critical Care, Department of Anesthesiology and Critical Care Medicine, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa. 5. Division of Critical Care, Department of Anesthesiology and Critical Care Medicine, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa; Division of Cardiology, Department of Pediatrics, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa.
Abstract
OBJECTIVE: To report practice and outcomes in infants undergoing elective repair of tetralogy of Fallot. METHODS: A review of a retrospective cohort of elective complete repair of infants age 6 months or younger from 1995 to 2009 was performed. Patients were excluded because of previous interventions, hypercyanotic episodes, intensive care admissions, additional major cardiac defects, or if they were not discharged after birth. Length of stay, mortality, and complications were recorded. Association was determined using logistic or linear regression models and univariate testing determined the multivariate model. RESULTS: There were 277 patients included. The hospital mortality rate was zero. A total of 87.4% of patients were discharged home within 7 days of repair, and 21.6% of patients were discharged on or before the third postoperative day. The postoperative course was uncomplicated in 245 patients (88.4%). Longer support time was associated independently with increased odds of complications (P < .001). Longer support time, younger age, chromosomal abnormality, and presence of a complication were associated independently with a longer hospital stay (all P < .001). Patients younger than 3 months (n = 110) had a longer median hospital stay (4 vs 3 days; P < .001) and longer support times (77.3 ± 35.1 min vs 66.4 ± 34 min; P < .01). CONCLUSIONS: Elective tetralogy of Fallot repair was performed at 6 months or younger with low morbidity, no hospital mortality, and an 11.6% complication rate. Longer support times, lower weight, chromosomal abnormalities, and complications were associated with a significantly increased duration of hospital stay.
OBJECTIVE: To report practice and outcomes in infants undergoing elective repair of tetralogy of Fallot. METHODS: A review of a retrospective cohort of elective complete repair of infants age 6 months or younger from 1995 to 2009 was performed. Patients were excluded because of previous interventions, hypercyanotic episodes, intensive care admissions, additional major cardiac defects, or if they were not discharged after birth. Length of stay, mortality, and complications were recorded. Association was determined using logistic or linear regression models and univariate testing determined the multivariate model. RESULTS: There were 277 patients included. The hospital mortality rate was zero. A total of 87.4% of patients were discharged home within 7 days of repair, and 21.6% of patients were discharged on or before the third postoperative day. The postoperative course was uncomplicated in 245 patients (88.4%). Longer support time was associated independently with increased odds of complications (P < .001). Longer support time, younger age, chromosomal abnormality, and presence of a complication were associated independently with a longer hospital stay (all P < .001). Patients younger than 3 months (n = 110) had a longer median hospital stay (4 vs 3 days; P < .001) and longer support times (77.3 ± 35.1 min vs 66.4 ± 34 min; P < .01). CONCLUSIONS: Elective tetralogy of Fallot repair was performed at 6 months or younger with low morbidity, no hospital mortality, and an 11.6% complication rate. Longer support times, lower weight, chromosomal abnormalities, and complications were associated with a significantly increased duration of hospital stay.
Keywords:
20; 41.1; ACC; CPB; DHCA; LOS; LSCA; RAA; TOF; TST; aortic cross-clamp; cardiopulmonary bypass; deep hypothermic circulatory arrest; left subclavian artery; length of stay; right aortic arch; tetralogy of Fallot; total support time
Authors: Jill J Savla; Jennifer A Faerber; Yuan-Shung V Huang; Theoklis Zaoutis; Elizabeth Goldmuntz; Steven M Kawut; Laura Mercer-Rosa Journal: J Am Coll Cardiol Date: 2019-09-24 Impact factor: 24.094
Authors: Scott A Simpson; Suzanne L Field; Meng Xu; Benjamin R Saville; David A Parra; Jonathan H Soslow Journal: Pediatr Cardiol Date: 2017-12-14 Impact factor: 1.655
Authors: Jyoti K Patel; Andrew C Glatz; Reena M Ghosh; Shannon M Jones; Shobha Natarajan; Chitra Ravishankar; Christopher E Mascio; Thomas L Spray; Meryl S Cohen Journal: Circulation Date: 2015-08-05 Impact factor: 29.690
Authors: Bryan H Goldstein; Christopher J Petit; Athar M Qureshi; Courtney E McCracken; Michael S Kelleman; George T Nicholson; Mark A Law; Jeffery J Meadows; Jeffrey D Zampi; Shabana Shahanavaz; Christopher E Mascio; Paul J Chai; Jennifer C Romano; Sarosh P Batlivala; Shiraz A Maskatia; Ivor B Asztalos; Alicia M Kamsheh; Steven J Healan; Justin D Smith; R Allen Ligon; Joelle A Pettus; Sarina Juma; James E B Raulston; Krissie M Hock; Amy L Pajk; Lindsay F Eilers; Hala Q Khan; Taylor C Merritt; Matthew Canter; Stephan Juergensen; Fatuma-Ayaan Rinderknecht; Holly Bauser-Heaton; Andrew C Glatz Journal: J Am Coll Cardiol Date: 2021-03-02 Impact factor: 24.094
Authors: Izabela F Martins; Iara C Doles; Nathalie J M Bravo-Valenzuela; Adriana O R Dos Santos; Marcela S P Varella Journal: Braz J Cardiovasc Surg Date: 2018 Sep-Oct
Authors: Laura Mercer-Rosa; Okan U Elci; Grace DeCost; Stacy Woyciechowski; Sharon M Edman; Chitra Ravishankar; Christopher E Mascio; Steven M Kawut; Elizabeth Goldmuntz Journal: J Am Heart Assoc Date: 2018-05-16 Impact factor: 5.501