Publicação

Postoperative Complications in Humanitarian Paediatric Patients Undergoing Late Surgical Correction of Tetralogy of Fallot

Detalhes bibliográficos
Resumo:	Background: Tetralogy of Fallot is a congenital heart defect that requires early surgical correction. However, in developing countries, many patients undergo delayed treatment due to limited healthcare resources. This study aims to identify risk factors for postoperative complications in humanitarian patients undergoing late Tetralogy of Fallot repair, defined as surgery performed after 12 months of age. Methods: A retrospective analysis was conducted on 115 humanitarian paediatric patients with a median age of 1444 days (approximately 4 years) who underwent complete Tetralogy of Fallot correction. In this humanitarian programme, patients from developing nations underwent surgical repair at our tertiary referral centre in a high-resource country. Postoperative complications were monitored within the first 30 days after surgery. Two multivariable logistic regression models were used to analyse pre/perioperative (Model 1) and postoperative (Model 2) risk factors for complications. Results: Complications occurred in 24.3% of patients. No deaths were recorded. In Model 1, smaller pulmonary valve annulus (OR = 0.066; p < 0.01) and the use of right ventricle to pulmonary artery conduit (OR = 13.252; p < 0.01) were significantly associated with a higher risk of complications. In Model 2, prolonged invasive ventilation time (OR = 1.068; p < 0.01) and extended hospitalisation time (OR = 1.093; p = 0.04) were significantly associated with complications. Conclusions: Late surgical correction of Tetralogy of Fallot in humanitarian paediatric patients can be performed with low mortality but carries a significant risk of postoperative complications. The predictive models provide useful tools for proactive clinical monitoring, personalised management, and optimisation of hospital resources.
Autores principais:	Mendes, Vitor
Outros Autores:	Filliol, Samuel; Nalecz, Tomasz; Abecasis, Ana; Pereira, Telmo; Martins, Maria do Rosário Oliveira; Wacker, Julie; Sologashvili, Tornike
Assunto:	humanitarian patients late complete surgical repair postoperative complications Tetralogy of Fallot Pediatrics, Perinatology, and Child Health
Ano:	2025
País:	Portugal
Tipo de documento:	artigo
Tipo de acesso:	acesso aberto
Instituição associada:	Universidade Nova de Lisboa
Idioma:	inglês
Origem:	Repositório Institucional da UNL

Descrição
Resumo:	Background: Tetralogy of Fallot is a congenital heart defect that requires early surgical correction. However, in developing countries, many patients undergo delayed treatment due to limited healthcare resources. This study aims to identify risk factors for postoperative complications in humanitarian patients undergoing late Tetralogy of Fallot repair, defined as surgery performed after 12 months of age. Methods: A retrospective analysis was conducted on 115 humanitarian paediatric patients with a median age of 1444 days (approximately 4 years) who underwent complete Tetralogy of Fallot correction. In this humanitarian programme, patients from developing nations underwent surgical repair at our tertiary referral centre in a high-resource country. Postoperative complications were monitored within the first 30 days after surgery. Two multivariable logistic regression models were used to analyse pre/perioperative (Model 1) and postoperative (Model 2) risk factors for complications. Results: Complications occurred in 24.3% of patients. No deaths were recorded. In Model 1, smaller pulmonary valve annulus (OR = 0.066; p < 0.01) and the use of right ventricle to pulmonary artery conduit (OR = 13.252; p < 0.01) were significantly associated with a higher risk of complications. In Model 2, prolonged invasive ventilation time (OR = 1.068; p < 0.01) and extended hospitalisation time (OR = 1.093; p = 0.04) were significantly associated with complications. Conclusions: Late surgical correction of Tetralogy of Fallot in humanitarian paediatric patients can be performed with low mortality but carries a significant risk of postoperative complications. The predictive models provide useful tools for proactive clinical monitoring, personalised management, and optimisation of hospital resources.