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Younger age remains a risk factor for prolonged length of stay after bidirectional cavopulmonary anastomosis

  • Andrew M. Koth (a1), Claudia A. Algaze (a1), Charlotte Sakarovitch (a2), Jin Long (a2), Komal Kamra (a3), Gail E. Wright (a1), Bambi Alexander-Banys (a1), Katsuhide Maeda (a2) and Andrew Y. Shin (a1)...



This study sets out to determine the influence of age at the time of surgery as a risk factor for post-operative length of stay after bidirectional cavopulmonary anastomosis.


All patients undergoing a Glenn procedure between January 2010 and July 2015 were included in this retrospective cohort study. Demographic data were examined. Standard descriptive statistics was used. A univariable analysis was conducted using the appropriate test based on data distribution. A propensity score for balancing the group difference was included in the multi-variable analysis, which was then completed using predictors from the univariable analysis that achieved significance of p<0.1.


Over the study period, 50 patients met the inclusion criteria. Patients were separated into two cohorts of ⩾4 months (28 patients) and <4 months (22 patients). Other than height and weight, the two cohorts were indistinguishable in their pre-operative saturation, medications, catheterisation haemodynamics, atrioventricular valve regurgitation, and ventricular function. After adjusting group differences, younger age was associated with longer post-operative length of hospitalisation – adjusted mean 15 (±2.53) versus 8 (±2.15) days (p=0.03). In a multi-variable regression analysis, in addition to ventricular dysfunction (β coefficient=8.8, p=0.05), Glenn procedures performed before 4 months were independently associated with longer length of stay (β coefficient=−6.9, p=0.03).


We found that Glenn procedures performed after 4 months of age had shorter post-operative length of stay when compared to a younger cohort. These findings suggest that balancing timing of surgery to decrease the inter-stage period should take into consideration differences in post-operative recovery with earlier operations.


Corresponding author

Author for correspondence: Andrew Koth, Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children’s Hospital, Stanford, CA, USA. E-mail:


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Cite this article: Koth AM, Algaze CA, Sakarovitch C, Long J, Kamra K, Wright GE, Alexander-Banys B, Maeda K, Shin AY. (2019) Younger age remains a risk factor for prolonged length of stay after bidirectional cavopulmonary anastomosis. Cardiology in the Young29: 369–374. doi: 10.1017/S1047951118002470



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