Results for surgical correction of complete atrioventricular septal defect: associations with age, surgical era, and technique

J Card Surg. 2012 Nov;27(6):745-53. doi: 10.1111/jocs.12016.

Abstract

Background: This study was conducted to evaluate the outcomes of patients undergoing complete atrioventricular septal defect (CAVSD) repair with particular attention to age at surgery, surgical era, and technique.

Methods: One hundred and forty-seven patients undergoing CAVSD repair between November 2002 and February 2012 were grouped according to surgical era and technique. Group I (age: 9.4 ± 5.0 months; weight: 6.8 ± 1.7 kg) consisted of 45 patients, operated before August 2006, and was divided into subgroup Ia (31 patients; two-patch repair) and subgroup Ib (14 patients; modified single-patch repair). One hundred and two patients operated after August 2006 were included in Group II (age: 5.2 ± 3.1 months; weight: 4.9 ± 2.6 kg), and was divided into subgroup IIa (59 patients; two-patch repair) and subgroup IIb (43 patients; modified single-patch repair). Groups were compared with regard to perioperative variables and postoperative data.

Results: There were 19 early and five late deaths. Overall mortality was significantly higher in Group I, compared to Group II (p < 0.01). Comparison of Groups Ia to Ib and IIa to IIb revealed no statistically significant difference in mortality or morbidity. Age >8 months and preoperative common atrioventricular valve (CAVV) regurgitation ≥ moderate were significant risk factors for mortality and morbidity. After 40.8 ± 24.4 months, 99 (80.4%) of 123 (83.7%) survivors were asymptomatic without any medication, and 24 (19.5%) have mild symptoms.

Conclusion: Our current results indicate that younger patient age and better preoperative CAVV functions were the main factors for a favorable outcome after surgical correction of CAVSD; and outcomes did not differ by the surgical technique.

MeSH terms

  • Age Factors
  • Body Weight
  • Cardiac Surgical Procedures / methods*
  • Female
  • Heart Septal Defects / surgery*
  • Heart Valve Diseases / physiopathology
  • Heart Valves / physiopathology
  • Humans
  • Infant
  • Male
  • Preoperative Period
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Supplementary concepts

  • Atrioventricular Septal Defect