Document Detail


Development of left atrioventricular valve regurgitation after correction of atrioventricular septal defect.
MedLine Citation:
PMID:  15680844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left-sided atrioventricular valve regurgitation is the main indication for reoperation in patients after repair of both partial and complete atrioventricular septal defect. Until now, the timing for reoperation is difficult. We sought to determine the outcome of severe residual left-sided atrioventricular valve regurgitation, either medically treated or reoperation. In this regard risk factors were determined for severe residual left-sided atrioventricular valve regurgitation and reoperation, and the most appropriate strategy for patients with postoperative severe left-sided atrioventricular valve regurgitation was identified. METHODS: Retrospective review of clinical, operative, and echocardiographic data was performed. From 1990 until 2001 164 patients underwent correction of their atrioventricular septal defect. RESULTS: Five patients died in the immediate postoperative period, and 2 patients were lost to follow-up. During follow-up (median, 66 months; range, 9 months to 12 years), 30 patients (19%) had severe left-sided atrioventricular valve regurgitation. Sixteen patients had severe left-sided atrioventricular valve regurgitation in the immediate postoperative period; 4 of them showed spontaneous regression to near-normal valve function during follow-up. Fourteen patients exhibited left-sided atrioventricular valve regurgitation during follow-up; 8 of them remained stable with medication only. Fifteen of the 30 patients with severe left-sided atrioventricular valve regurgitation underwent reoperation. A significant risk factor for the development of severe left-sided atrioventricular valve regurgitation and reoperation was the presence of preoperative severe left-sided atrioventricular valve regurgitation. CONCLUSIONS: Severe left-sided atrioventricular valve regurgitation develops in a significant number of patients after correction of atrioventricular septal defect, and preoperative severe left-sided atrioventricular valve regurgitation is an important risk factor. Although reoperation usually results in good valve function, spontaneous regression after the immediate postoperative period is possible and should be given a fair chance.
Authors:
A Derk Jan Ten Harkel; Adri H Cromme-Dijkhuis; Bianca C C Heinerman; Wim C Hop; Ad J J C Bogers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  79     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-31     Completed Date:  2005-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  607-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Cardiology, Erasmus MC-Sophia, Rotterdam, The Netherlands. a.tenharkel@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cardiac Surgical Procedures / adverse effects,  mortality
Child
Child, Preschool
Female
Follow-Up Studies
Heart Septal Defects, Atrial / surgery*
Heart Septal Defects, Ventricular / surgery*
Humans
Infant
Male
Mitral Valve Insufficiency / etiology*,  surgery*
Multivariate Analysis
Reoperation / adverse effects,  mortality
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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