Korean J Thorac Cardiovasc Surg.  2009 Jun;42(3):299-304.

Surgical Treatment of Complete Atrioventricular Septal Defect: The Early and Mid-Term Results

• Kim H
• Jun TG
• Yang JH
• Park PW
• Kim WS
• Lee YT
• Sung K

Abstract

BACKGROUND: Although the results of the surgical management for complete atrioventricular septal defect (c-AVSD) have improved, the optimal surgical strategy is still controversial. The aims of this study are to evaluate the outcome of c-AVSD repair and to define the risk factors related to reoperation. MATERIAL AND METHOD: We retrospectively reviewed the medical records of 35 patients (8 males and 27 females) who underwent the total correction of c-AVSD from August 1996 to March 2008. The median age at repair was 5.2 months (range: 3 days~82 months). Sixteen patients (45.7%) were associated with Down syndrome. Prior palliative operations were performed in 4 patients. The one-patch techniques were performed in 3 patients, and the two-patch techniques were done in 32 patients. RESULT: There was 1 early death (2.9%). The median follow-up period was 68 months (range: 2~134 months) for 34 survivors. There was no late death. Reoperations were performed in 5 patients (14.3%) for severe left atrioventricular valvular regurgitation (AVVR). Nine patients (25.7%) showed left an AVVR of more than grade III. Associated major cardiac anomalies and the use of Gore-Tex patch for ventricular septal closure were the risk factors for postoperative left atrioventricular valve failure and reoperation.
CONCLUSION
In this study, we found that surgical repair of c-AVSD was safe and effective. However, the high reoperation rate after repair remains a problem to be solved.

Keyword

Congenital heart disease (CHD); Atrioventricular septal defect; Atrioventricular valve insufficiency

MeSH Terms

Down Syndrome
Follow-Up Studies
Heart Septal Defects
Humans
Male
Medical Records
Mitral Valve Insufficiency
Polytetrafluoroethylene
Reoperation
Retrospective Studies
Risk Factors
Survivors
Heart Septal Defects
Mitral Valve Insufficiency
Polytetrafluoroethylene