Alifu Ailixiati, Wang Haifan, Chen Renwei
Department of Cardiothoracic Surgery, Hainan Women and Children's Medical Center, Haikou, Hainan, China.
Front Pediatr. 2024 Jan 31;12:1274913. doi: 10.3389/fped.2024.1274913. eCollection 2024.
This study aimed to investigate the relationship between technical performance scores (TPS) and the early prognosis of tetralogy of Fallot repair (TOF).
A retrospective study was conducted on TOF repair patients at our center from Oct 2017 to Oct 2022. Patients were classified into Class 1 (no residua), Class 2 (minor residua), or Class 3 (major residua) based on TPS derived from predischarge echocardiograms and need for reintervention. Statistical methods were used to assess the association between TPS and early prognosis.
A total of 75 TOF repair patients (40% female, 60% male) were analyzed and categorized into TPS1 (24%), TPS2 (53.3%), and TPS3 (22.6%) based on pre-discharge echocardiographic findings. The median follow-up time was 7.0 months. The multivariable Cox regression analysis indicated that TPS3 scores are associated with a 12.68-fold increase in risk compared to TPS1 and TPS2 scores [95% CI = 12.68 (0.9∼179.28), = 0.06]. The Spearman rank correlation analysis revealed a weak positive correlation between TPS classification and low cardiac output syndrome ( = 0.26, = 0.03). However, there were no significant differences in ICU stay or duration of mechanical ventilation among the groups.
TPS3 after intracardiac TOF repair is associated with higher risk of early re-intervention, highlighting the importance of close follow-up and monitoring in this patient population. Patients who develop low cardiac output syndrome in the early postoperative period may have residual defects that require prompt identification.
本研究旨在探讨技术性能评分(TPS)与法洛四联症修复术(TOF)早期预后之间的关系。
对2017年10月至2022年10月在本中心接受TOF修复术的患者进行回顾性研究。根据出院前超声心动图得出的TPS以及再次干预的必要性,将患者分为1类(无残留)、2类(轻度残留)或3类(重度残留)。采用统计方法评估TPS与早期预后之间的关联。
共分析了75例TOF修复术患者(40%为女性,60%为男性),并根据出院前超声心动图结果将其分为TPS1(24%)、TPS2(53.3%)和TPS3(22.6%)。中位随访时间为7.0个月。多变量Cox回归分析表明,与TPS1和TPS2评分相比,TPS3评分的风险增加了12.68倍[95%置信区间=12.68(0.9∼179.28),P=0.06]。Spearman等级相关分析显示TPS分类与低心排血量综合征之间存在弱正相关(r=0.26,P=0.03)。然而,各组之间在重症监护病房停留时间或机械通气持续时间方面无显著差异。
心内TOF修复术后的TPS3与早期再次干预的较高风险相关,突出了对该患者群体进行密切随访和监测的重要性。术后早期发生低心排血量综合征的患者可能存在需要及时识别的残留缺陷。