title: Primary tetralogy of Fallot repair: predictors of intensive care unit morbidity.
abstract: BACKGROUND
  Primary repair of tetralogy of Fallot has low surgical mortality, but some patients still experience significant postoperative morbidity. Our objectives were to review our institutional experience with primary tetralogy of Fallot repair, and identify predictors of intensive care unit morbidity.
  
  
  METHODS
  We reviewed all patients with tetralogy of Fallot who underwent primary repair in infancy from 2001 to 2012. Preoperative, operative, and postoperative demographic and morphologic data were analyzed. Intensive care unit morbidity was defined as prolonged intensive care unit stay (≥ 7 days) and/or prolonged duration of mechanical ventilation (≥ 48 h).
  
  
  RESULTS
  97 patients who underwent primary surgical repair during the study period were included in the study. The median age was 4.9 months (range 1-9 months) and the median weight was 5.3 kg (range 3.1-9.8 kg). There was no early surgical mortality. The incidence of junctional ectopic tachycardia and persistent complete heart block was 2% and 1%, respectively. The median intensive care unit stay was 6 days (range 2-21 days) and the median duration of mechanical ventilation was 19 h (range 0-136 h). Age and weight were independent predictors of intensive care unit stay, while surgical era predicted the duration of mechanical ventilation.
  
  
  CONCLUSIONS
  Primary tetralogy of Fallot repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery were significant predictors of morbidity.
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, USA cegbe2001@yahoo.com.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Egbe
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, USA.
authors.forename: Santosh C
authors.initials: SC
authors.lastname: Uppu
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, USA.
authors.forename: Alexander J C
authors.initials: AJ
authors.lastname: Mittnacht
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, USA.
authors.forename: Umesh
authors.initials: U
authors.lastname: Joashi
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ho
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, USA.
authors.forename: Khanh
authors.initials: K
authors.lastname: Nguyen
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, USA.
authors.forename: Shubhika
authors.initials: S
authors.lastname: Srivastava
mesh_terms: D000367:Age Factors; D001835:Body Weight; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D009519:New York City; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013771:Tetralogy of Fallot / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Infant; artificial; postoperative complications; respiration; risk factors; tetralogy of Fallot