| Long-term results after repair of complete atrioventricular septal defect with two-patch technique. | |
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MedLine Citation:
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PMID: 20338343 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Surgical management of patients with complete atrioventricular septal defect (AVSD) has advanced over the last decades. Definitive early surgical repair for AVSD has become the treatment of choice at many centers. This trend has contributed to the recent decline in postoperative mortality and good long-term results. METHODS: We reviewed long-term results of 100 consecutive patients with complete AVSD undergoing definitive early repair with a two-patch technique and complete cleft closure operated on between June 1999 and June 2009. Valve performance, mortality, morbidity, and indications for reoperation were retrospectively studied. RESULTS: Median age at operation was 3.8 months (range, 15 days to 4.7 years); median weight was 5.0 kg (range, 3.0 to 19 kg). Follow-up was 99% complete (mean 58 months; range, 1 to 120 months). Early definitive repair was performed in all patients who initially presented to our institution over the study period. There was no perioperative, in-hospital mortality, or late mortality. At the latest follow up, left atrioventricular valve (LAVV) regurgitation was absent or trace in 80 patients (80%), mild to moderate in 15 patients (15%), and moderate to severe in 4 patients (4%). Right AV valve regurgitation was none or trace in 86 patients (86%), mild to moderate in 11 patients (11%), and moderate to severe in 2 patients (2%). Actuarial freedom from reoperation for LAVV dysfunction at 1, 3, 5, and 10 years was 98%, 95%, 94%, and 94%, respectively. Actuarial freedom from reoperation for left ventricular outflow tract obstruction at 1, 3, 5, and 10 years was 100%, 99%, and remained constant by 99% at 5 and 10 years. CONCLUSIONS: Definitive early repair for complete AVSD can be performed with excellent results. The two-patch technique with complete cleft closure is a safe and reproducible surgical method that can achieve very low mortality and stable long-term outcomes, even in neonates. |
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Authors:
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Farhad Bakhtiary; Judith Takacs; Mi-Young Cho; Vit Razek; Ingo D?hnert; Torsten Doenst; Thomas Walther; Michael Andrew Borger; Friedrich Wilhelm Mohr; Martin Kostelka |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 89 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-26 Completed Date: 2010-04-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1239-43 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiac Surgery, University of Leipzig, Heart Centre, Leipzig, Germany. farhad@bakhtiary.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Surgical Procedures
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methods Child, Preschool Female Heart Septal Defects / surgery* Humans Infant Infant, Newborn Male Polytetrafluoroethylene* Retrospective Studies Time Factors |
| Chemical | |
Reg. No./Substance:
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9002-84-0/Polytetrafluoroethylene |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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