Clinical and intraoperative determinants of intensive care unit length of stay after radical surgical repair of tetralogy of Fallot in children
Received: 2026-10-05
Published: 2026-03-30
Abstract
Background: Tetralogy of Fallot is the most common cyanotic congenital heart defect requiring radical surgical repair in early childhood; intensive care unit (ICU) length of stay remains a clinically and economically important indicator of treatment efficiency. Objective: To identify clinical and intraoperative parameters associated with ICU length of stay after radical repair of tetralogy of Fallot.
Materials and Methods: A retrospective analysis of 101 radical repairs performed at the National Children’s Medical Center in Tashkent was conducted. Age, oxygen saturation, left ventricular end-diastolic index, cardiopulmonary bypass and aortic cross-clamp times, repair type, residual ventricular septal defect, residual pulmonary artery stenosis, and pulmonary valve regurgitation were assessed. Associations with ICU stay were evaluated using Spearman correlation, Kruskal–Wallis, and Mann–Whitney tests.
Results: Mean ICU stay was 70.4±49.6 h. Significant associations were found with age (r=-0.389; p=0.0001), cardiopulmonary bypass duration (r=0.370; p=0.0002), aortic cross-clamp time (r=0.314; p=0.0016), and pulmonary valve regurgitation grade (r=0.280; p=0.0046). Valve-sparing repair was associated with a shorter ICU stay than transannular techniques (p=0.0072).
Conclusions: ICU duration after tetralogy of Fallot repair is determined by a combination of age-related, intraoperative, and valve-associated factors, supporting a differentiated approach to surgical strategy.
Keywords
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