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Type: Journal article
Title: Outcomes of repair of complete atrioventricular septal defect in the current era
Author: Xie, O.
Brizard, C.
D'udekem, Y.
Galati, J.
Kelly, A.
Yong, M.
Weintraub, R.
Konstantinov, I.
Citation: European Journal of Cardio-Thoracic Surgery, 2014; 45(4):610-617
Publisher: Oxford University Press
Issue Date: 2014
ISSN: 1010-7940
Statement of
Ouli Xie, Christian P. Brizard, Yves d'Udekem, John C. Galati, Andrew Kelly, Matthew S. Yong, Robert G. Weintraub and Igor E. Konstantinov
Abstract: OBJECTIVES: We sought to evaluate the surgical outcomes of the repair of complete atrioventricular septal defects (cAVSDs) in our institution in the current era. METHODS: From 2000 to 2011, 138 patients underwent definitive repair of cAVSD. Repair was performed using a two-patch technique in 92.0% of patients and one-patch technique in 2.2%, and the ventricular septal component was closed directly in 5.8% of patients. RESULTS: Operative mortality was 1.4% (2 of 138). Overall mortality was 5.8% (8 of 138). Follow-up was 96% complete. Freedom from reoperation was 84.3% (95% CI 77.1-91.5%) at 8 years. Age >6 months at repair was associated with higher rates of reoperation (P = 0.001; HR 6.85; 95% CI 2.30-20.44). However, operating at <6 months of age was associated with longer intensive care unit stay (P = 0.019; median 2.7 vs 1.4 days), mechanical ventilation (P = 0.001; median 1.7 vs 0.9 days) and postoperative hospital stay (P = 0.016; median 8 vs 5 days). Moderate or greater left atrioventricular valvular regurgitation (LAVVR) at discharge was a risk factor for reoperation (P < 0.001; HR 10.85; 95% CI 3.75-31.40). CONCLUSIONS: Repair of cAVSD carries low mortality, but a moderate reoperation rate. An optimal time for repair of the cAVSD is between 3 and 6 months of age. Repair prior to 3 months of age and the need for cleft closure were associated with a higher degree of LAVVR at discharge. Greater LAVVR at discharge is a risk factor for reoperation regardless of age at initial repair. In the current era, Down's syndrome is not a risk factor for reoperation.
Keywords: Atrioventricular septal defect; Surgery; Outcomes
Description: First published online: September 20, 2013
Rights: © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
RMID: 0030016295
DOI: 10.1093/ejcts/ezt444
Appears in Collections:Paediatrics publications

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