This was a retrospective study of consecutive adult patients undergoing surgical intervention between 1995 and 2006. A multivariate logistic regression model was used to identify determinants of prolonged hospitalization.
One hundred sixteen patients (mean age, 36 ± 11 years) underwent 118 pulmonary valve replacements. Most (95 % ) operations included additional procedures, such as pulmonary artery/outflow tract reconstruction or tricuspid valve annuloplasty. The early postoperative mortality (<30 days) was 2.5 % . The majority of the patients (60 % ) had no postoperative complications. The postoperative adverse events included postoperative arrhythmias (19 % ), respiratory complications (13 % ), reoperation during admission (13 % ), renal dysfunction (13 % ), and myocardial infarction (3 % ). Postoperative adverse events were associated with prolonged hospitalization (14 ± 12 vs 7 ± 3 days, P = .001). In the multivariate analysis age at reoperation of greater than 45 years (odds ratio, 6.1; 95 % confidence interval, 1.6–23.6; P = .009), the number of previous sternotomies (odds ratio, 3.8; 95 % confidence interval, 1.4–10; P = .007), and the need for urgent surgical intervention (odds ratio, 5.7; 95 % confidence interval, 1.1–27.8; P = .03) were predictors of prolonged hospitalization.
Pulmonary valve replacement in adults with repaired tetralogy of Fallot has a low mortality risk. The most common early postoperative complications are arrhythmias and respiratory and renal complications. Although most early postoperative complications do not result in long-term sequelae, they are associated with prolonged hospitalization. Patients undergoing urgent interventions, older patients, and those with multiple previous sternotomies are at the highest risk for prolonged hospitalization.