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Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot
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Resumo(s)
Introduction: The optimal surgical approach for right ventricular outflow tract obstruction in Tetralogy of Fallot aims to preserve the native pulmonary valve annulus, as this is associated with better long-term outcomes. Pediatric humanitarian patients often present with a delayed diagnosis and lack access to preoperative palliative treatments, reducing the likelihood of pulmonary valve annulus preservation and potentially compromising long-term outcomes. This study aims to identify independent predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients undergoing corrective surgery for Tetralogy of Fallot. Methods: Between January 2019 and May 2023, pediatric humanitarian patients with Tetralogy of Fallot underwent surgical correction at our center. We performed a comparative analysis of preoperative, intraoperative, and postoperative variables, followed by univariate and multivariate logistic regression to identify independent predictors of pulmonary valve-sparing repair. Results: A lower body mass index (OR = 0.711; p = 0.021; 95% CI = 0.533–0.949), a larger pulmonary valve annulus measured in centimeters (OR = 28.653; p = 0.008; 95% CI = 2.360-347.890) and a higher Z-score of pulmonary valve annulus (OR = 1.606; p = 0.023; 95% CI = 1.067–2.418) were identified as independent predictors of pulmonary valve-sparing repair. Conclusion: Successful pulmonary valve-sparing repair was associated with lower BMI and a larger pulmonary valve annulus (both measurements in centimeters and Z-score). These findings may help guide clinical and policy strategies to promote more equitable and effective surgical care in resource-limited settings.
Descrição
Funding Information: Open access funding provided by University of Geneva. Publisher Copyright: © The Author(s) 2025.
Palavras-chave
Pediatric humanitarian patients Pulmonary valve-sparing repair Tetralogy of Fallot Surgery Pulmonary and Respiratory Medicine Cardiology and Cardiovascular Medicine