La desnutrición, anatomía desfavorable, tiempo de circulación extracorpórea y el tiempo de pinzamiento aórtico son factores de riesgo de mortalidad quirúrgica en cirugía correctiva en pacientes pediátricos con Tetralogía de Fallot, en la Unidad de Cuidados Intensivos Cardiológicos del Hospital Roberto Gilbert Elizalde de Guayaquil, de enero de 2013 a diciembre de 2019.

Abstract

Background: Congenital heart disease is an important cause of mortality in children under one year of age, and tetralogy of Fallot is the most common cyanotic congenital heart defect, and its treatment is always surgical. Several studies have determined risk factors for postoperative mortality in cardiac surgery, which is why we decided to validate malnutrition, unfavorable anatomy, aortic clamping time and CPB time, specifically in corrective Fallot surgery. Materials and Methods: A retrospective, observational, cross-sectional and analytical study was carried out, investigating possible risk factors for mortality in corrective Fallot surgery, in patients from 1 month to 17 years old admitted to the Cardiological Intensive Care Unit at the Roberto Gilbert Hospital from 2013 to 2019. Pre-surgical, trans-surgical and postsurgical variables were recorded, the patients were divided into 2 groups, those who survived and those who died, to analyze the difference in means and chi square, looking for a direct association with mortality. Results: Of the 122 patients, the overall mortality was 9.8%. The variables studied do not present statistical significance: malnutrition (p = 0.32), unfavorable anatomy (p = 0.53), ECC time (p = 0.05) and aortic clamping time (p = 0.56) . Conclusions: Malnutrition, unfavorable anatomy, ECC time and aortic clamping time are not risk factors that increase mortality in corrective Fallot surgery. The risk factors that did increase it were: the days of mechanical ventilation, neurological complications, kidney complications and MOF.