{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:39:27Z","timestamp":1760060367530,"version":"build-2065373602"},"reference-count":17,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Tetralogy of Fallot is a congenital heart defect that requires early surgical correction. However, in developing countries, many patients undergo delayed treatment due to limited healthcare resources. This study aims to identify risk factors for postoperative complications in humanitarian patients undergoing late Tetralogy of Fallot repair, defined as surgery performed after 12 months of age. Methods: A retrospective analysis was conducted on 115 humanitarian paediatric patients with a median age of 1444 days (approximately 4 years) who underwent complete Tetralogy of Fallot correction. In this humanitarian programme, patients from developing nations underwent surgical repair at our tertiary referral centre in a high-resource country. Postoperative complications were monitored within the first 30 days after surgery. Two multivariable logistic regression models were used to analyse pre\/perioperative (Model 1) and postoperative (Model 2) risk factors for complications. Results: Complications occurred in 24.3% of patients. No deaths were recorded. In Model 1, smaller pulmonary valve annulus (OR = 0.066; p &lt; 0.01) and the use of right ventricle to pulmonary artery conduit (OR = 13.252; p &lt; 0.01) were significantly associated with a higher risk of complications. In Model 2, prolonged invasive ventilation time (OR = 1.068; p &lt; 0.01) and extended hospitalisation time (OR = 1.093; p = 0.04) were significantly associated with complications. Conclusions: Late surgical correction of Tetralogy of Fallot in humanitarian paediatric patients can be performed with low mortality but carries a significant risk of postoperative complications. The predictive models provide useful tools for proactive clinical monitoring, personalised management, and optimisation of hospital resources.<\/jats:p>","DOI":"10.3390\/children12091111","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:09:32Z","timestamp":1756080572000},"page":"1111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Complications in Humanitarian Paediatric Patients Undergoing Late Surgical Correction of Tetralogy of Fallot: A Multivariate Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6369-5784","authenticated-orcid":false,"given":"Vitor","family":"Mendes","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG), 1211 Geneva 14, Switzerland"},{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal"}]},{"given":"Samuel","family":"Filliol","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG), 1211 Geneva 14, Switzerland"}]},{"given":"Tomasz","family":"Nalecz","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG), 1211 Geneva 14, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3903-5265","authenticated-orcid":false,"given":"Ana","family":"Abecasis","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9119-7774","authenticated-orcid":false,"given":"Telmo","family":"Pereira","sequence":"additional","affiliation":[{"name":"H&TRC\u2014Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, 3045-043 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7941-0285","authenticated-orcid":false,"given":"Maria do Ros\u00e1rio Oliveira","family":"Martins","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5408-1107","authenticated-orcid":false,"given":"Julie","family":"Wacker","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Department of Women, Child and Adolescent Medicine, Geneva University Hospitals (HUG), University of Geneva, 1211 Geneva 14, Switzerland"}]},{"given":"Tornike","family":"Sologashvili","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals (HUG), 1211 Geneva 14, Switzerland"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.cjcpc.2023.12.002","article-title":"Tetralogy of Fallot in Low- and Middle-Income Countries","volume":"3","author":"Dib","year":"2024","journal-title":"CJC Pediatr. 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Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1053\/j.pcsu.2012.01.006","article-title":"Valve-Sparing Options in Tetralogy of Fallot Surgery","volume":"Volume 15","author":"Bacha","year":"2012","journal-title":"Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Domnina, Y.A., Kerstein, J., Johnson, J., Sharma, M.S., Kazmerski, T.M., Chrysostomou, C., and Munoz, R.A. (2020). Tetralogy of Fallot. Critical Care of Children with Heart Disease, Springer International Publishing.","DOI":"10.1007\/978-3-030-21870-6_18"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"(2013). World Medical Association Declaration of Helsinki. 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Surg."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1111\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:34:46Z","timestamp":1760034886000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,23]]},"references-count":17,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["children12091111"],"URL":"https:\/\/doi.org\/10.3390\/children12091111","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2025,8,23]]}}}