Postoperative mechanical ventilation after corrective Tetralogy of Fallot surgery in infants: Assessment of perioperative factors and radiographic severity scores.

Early recovery from surgery for congenital heart disease (CHD) is becoming a trend. Tetralogy of Fallot/pulmonary stenosis (TOF/PS) is the most common cyanotic CHD with excellent long-term outcomes. We examined potential factors associated with early extubation in 249 patients who underwent TOF/PS complete repair in a tertiary pediatric medical center from January 2015 to December 2022. Patient demographics, preoperative characteristics, intraoperative variables, postoperative outcomes, surgical type, surgical duration, cardiopulmonary bypass (CPB) time, cross-clamp time, and blood product volumes were acquired from the electronic medical records. Valve sparing repair (VSR) tends to demonstrate earlier recovery profiles than transannular patch repair (TAP) irrelevant of the presence of monocusp valve (P< 0.0001) and the degree of right ventricular outflow pressure drop was significantly correlated with post-operative recovery profile (p=0.0204). Because of intracardiac shunts and PaO ₂ /FiO ₂ ratios being poor indicators of lung injury, Brixia scores were also used. Our data suggested that Brixia score could be an excellent alternative to evaluate post-operative lung status.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Koichi Yuki reports financial support was provided by NICHD. Koichi Yuki reports a relationship with National Institute of Child Health and Human Development that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.