Mendes, VitorMouloudi, AbdelkhalekJolou, JalalNalecz, TomaszAbecasis, AnaPereira, Telmo S.Sologashvili, Tornike2025-07-312025-07-312025-121749-8090PURE: 123191123PURE UUID: a1da67d2-af72-4e2c-9f6e-b06d7b2186d5Scopus: 105006791075WOS: 001498518700003PubMed: 40437592PubMedCentral: PMC12117777http://hdl.handle.net/10362/185855Funding Information: Open access funding provided by University of Geneva. Publisher Copyright: © The Author(s) 2025.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.1264171engPediatric humanitarian patientsPulmonary valve-sparing repairTetralogy of FallotSurgeryPulmonary and Respiratory MedicineCardiology and Cardiovascular Medicinejournal article10.1186/s13019-025-03475-xhttps://www.scopus.com/pages/publications/105006791075