Document Detail


Primary biventricular repair of atrioventricular septal defects: an analysis of reoperations.
MedLine Citation:
PMID:  20732503     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  830-7     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Wessex Cardiothoracic Centre, Southampton University Hospitals, Southampton, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / 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:
Ann Thorac Surg. 2010 Sep;90(3):837-8   [PMID:  20732504 ]

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


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