ABSTRACT
<p><b>OBJECTIVE</b>To identify the risk factors of early postoperative death after total correction of tetralogy of Fallot (TOF).</p><p><b>METHODS</b>A retrospective analysis was conducted among 356 patients undergoing total correction of TOF by opening heart surgery and cardiopulmonary bypass. Of these patients, 20 died in the early postoperative period, and the possible risk factors for early postoperative death were analyzed in view of the surgical indication, surgical approaches, myocardial protection and postoperative management.</p><p><b>RESULTS</b>Of the 20 fatal cases, death occurred due to low cardiac output syndrome in 11 cases, respiratory failure in 4 cases, kidney failure or multiple organ failure in 3 cases, acute left heart failure in 1 case, and cerebrovascular accident in 1 case.</p><p><b>CONCLUSION</b>Young age at repair and poor development of the pulmonary vessels and left ventricle are high risk factors for postoperative low cardiac output syndrome. Postoperative death following surgical correction of TOF is associated mainly with the surgical skills and approaches. Appropriate cardiopulmonary bypass and effective measures for myocardial protection are critical to ensure the surgical success, and proper postoperative management and close monitoring may help reduce postoperative death in surgical patients with TOF.</p>