Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot
Abstract 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...
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| Format: | Article |
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BMC
2025-05-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03475-x |
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| author | Vitor Mendes Abdelkhalek Mouloudi Jalal Jolou Tomasz Nalecz Ana Abecasis Telmo Pereira Tornike Sologashvili |
| author_facet | Vitor Mendes Abdelkhalek Mouloudi Jalal Jolou Tomasz Nalecz Ana Abecasis Telmo Pereira Tornike Sologashvili |
| author_sort | Vitor Mendes |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-048317b8c8d34bebbfa3b64dd6d2e7da |
| institution | DOAJ |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-048317b8c8d34bebbfa3b64dd6d2e7da2025-08-20T03:16:56ZengBMCJournal of Cardiothoracic Surgery1749-80902025-05-0120111010.1186/s13019-025-03475-xPredictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of FallotVitor Mendes0Abdelkhalek Mouloudi1Jalal Jolou2Tomasz Nalecz3Ana Abecasis4Telmo Pereira5Tornike Sologashvili6Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG)Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG)Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG)Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG)Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon (IHMT-UNL)H&TRC - Health & Technology Research Center, Coimbra Health School, Polytechnic University of CoimbraDivision of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG)Abstract 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.https://doi.org/10.1186/s13019-025-03475-xTetralogy of FallotPulmonary valve-sparing repairPediatric humanitarian patients |
| spellingShingle | Vitor Mendes Abdelkhalek Mouloudi Jalal Jolou Tomasz Nalecz Ana Abecasis Telmo Pereira Tornike Sologashvili Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot Journal of Cardiothoracic Surgery Tetralogy of Fallot Pulmonary valve-sparing repair Pediatric humanitarian patients |
| title | Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot |
| title_full | Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot |
| title_fullStr | Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot |
| title_full_unstemmed | Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot |
| title_short | Predictors of successful pulmonary valve-sparing repair in pediatric humanitarian patients with Tetralogy of Fallot |
| title_sort | predictors of successful pulmonary valve sparing repair in pediatric humanitarian patients with tetralogy of fallot |
| topic | Tetralogy of Fallot Pulmonary valve-sparing repair Pediatric humanitarian patients |
| url | https://doi.org/10.1186/s13019-025-03475-x |
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