Abstract: Introduction: The need for prolonged mechanical ventilation for children with congenital heart disease after cardiac surgery has changed with the advances in surgical and perioperative care. Objectives: In the present study, we evaluated our six months experience with the fast-track protocol and investigated the preoperative predictors of successful outcome. Methods: Between July to December 2019, BSMMU, Dhaka, Bangladesh 60 consecutive patients undergoing cardiac surgery were preoperatively selected for post-operative admission in the postanaesthesia care unit (PACU) and were included in this study. These patients were then transferred to the ordinary ward on the same day of the operation. The primary end-point of the study was the success of the PACU protocol, defined as discharge to the ward on the same day, no further admission to the intensive care unit and no operative mortality. Logistic regression analysis was performed to detect the independent risk factors for failure of the PACU pathway. Results: 110 patients underwent cardiac surgical procedures in our institution. The majority of the patients were males (68.4%). The most important comorbidities were diabetes (16.7%), COPD (6.7%), previous cerebrovascular accident (CVA) (5%), peripheral vascular disease (10%), hypertension (45%), renal dysfunction (1.7%) and BMI >15 kg m−2 (8.3%). Using the multivariate logistic regression analysis, child age and left ventricular dysfunction were found to be independent risk factors for failure of the PACU protocol [odds ratio of 0.98/year (0.97–0.98) and 0.31 (0.14–0.70), respectively. Conclusions: Our fast-track management, called the PACU protocol, is efficient and safe for the postoperative management of selected patients undergoing cardiac surgery. Age and left ventricular dysfunction are significant preoperative predictors of failure of this protocol.