| Primary biventricular repair of atrioventricular septal defects: an analysis of reoperations. | |
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MedLine Citation:
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PMID: 20732503 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to analyze the factors affecting reoperation after primary biventricular atrioventricular septal defect (AVSD) repair. METHODS: Between April 1997 and April 2007, 93 consecutive patients underwent surgery for biventricular correction of AVSD with a median age of 5.8 months (range, 9 days to 68.9 years). Fifty-three patients had complete AVSD, 6 patients had an intermediate type, and 29 patients had partial AVSD; 4 patients had a complete AVSD with associated tetralogy of Fallot, and 1 patient had a complete AVSD with double-outlet right ventricle. RESULTS: There was no in-hospital mortality. There were 2 late deaths (2.2%). Forty-three reoperations were performed in 23 patients (24.7%), of which 18 were for repair of significant left atrioventricular valve regurgitation and 8 were mitral valve replacements. Seven patients (7.5%) required insertion of a permanent pacemaker. The overall 5-year freedom from reoperation after AVSD repair was 73.6% +/- 4.8%. In the multivariate analysis for complete AVSDs, Down syndrome (p = 0.01) and the presence of right ventricular dominance (p = 0.03) were independent predictors of reoperation. At last follow-up, 76 patients (83.5%) were in New York Heart Association class I, and 68 patients (74.7%) were not taking any heart failure medications. Echocardiographic examination showed absent to mild left atrioventricular valve regurgitation in 76.5%; moderate, in 19.8%; and severe, in 3.7% of patients. CONCLUSIONS: Down syndrome and right ventricular dominance are independent predictors of reoperation after complete AVSD repair. Biventricular repair of isolated AVSD with a small left ventricle can be successfully accomplished with no mortality. |
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Authors:
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Hunaid A Vohra; Alicia X F Chia; Ho Ming Yuen; Joseph J Vettukattil; Gruschen Veldtman; James Gnanapragasam; Kevin Roman; Anthony P Salmon; Marcus P Haw |
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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: 90 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-24 Completed Date: 2010-09-27 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: 830-7 Citation Subset: AIM; IM |
Copyright Information:
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2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Wessex Cardiothoracic Centre, Southampton University Hospitals, Southampton, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abnormalities, Multiple
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surgery* Adolescent Adult Aged Cardiac Surgical Procedures / methods Child Child, Preschool Female Heart Septal Defects, Atrial / surgery* Heart Septal Defects, Ventricular / surgery* Humans Infant Infant, Newborn Male Middle Aged Reoperation Retrospective Studies Time Factors Treatment Outcome Young Adult |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2010 Sep;90(3):837-8
[PMID:
20732504
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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