title: Results of elective repair at 6 months or younger in 277 patients with tetralogy of Fallot: a 14-year experience at a single center.
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.
authors.affiliation: 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.
authors.forename: Roxanne E
authors.initials: RE
authors.lastname: Kirsch
authors.affiliation: Division of Cardiology, Department of Pediatrics, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Glatz
authors.affiliation: Division of Cardiothoracic Surgery, Department of Pediatric Surgery, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa.
authors.forename: J William
authors.initials: JW
authors.lastname: Gaynor
authors.affiliation: Division of Critical Care, Department of Anesthesiology and Critical Care Medicine, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Nicolson
authors.affiliation: Division of Cardiothoracic Surgery, Department of Pediatric Surgery, Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, Pa.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Spray
authors.affiliation: 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.
authors.forename: Gil
authors.initials: G
authors.lastname: Wernovsky
authors.affiliation: 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.
authors.forename: Geoffrey L
authors.initials: GL
authors.lastname: Bird
mesh_terms: D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016009:Chi-Square Distribution; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D015143:Philadelphia; D012189:Retrospective Studies; D012307:Risk Factors; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
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