Outcomes of repair of complete atrioventricular septal defect in the current era

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dc.contributor.authorXie, O.
dc.contributor.authorBrizard, C.
dc.contributor.authorD'udekem, Y.
dc.contributor.authorGalati, J.
dc.contributor.authorKelly, A.
dc.contributor.authorYong, M.
dc.contributor.authorWeintraub, R.
dc.contributor.authorKonstantinov, I.
dc.date.issued2014
dc.descriptionFirst published online: September 20, 2013
dc.description.abstractOBJECTIVES: 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.
dc.description.statementofresponsibilityOuli Xie, Christian P. Brizard, Yves d'Udekem, John C. Galati, Andrew Kelly, Matthew S. Yong, Robert G. Weintraub and Igor E. Konstantinov
dc.identifier.citationEuropean Journal of Cardio-thoracic Surgery, 2014; 45(4):610-617
dc.identifier.doi10.1093/ejcts/ezt444
dc.identifier.issn1010-7940
dc.identifier.issn1873-734X
dc.identifier.urihttp://hdl.handle.net/2440/98583
dc.language.isoen
dc.publisherOxford University Press
dc.rights© The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
dc.source.urihttps://doi.org/10.1093/ejcts/ezt444
dc.subjectAtrioventricular septal defect; Surgery; Outcomes
dc.titleOutcomes of repair of complete atrioventricular septal defect in the current era
dc.typeJournal article
pubs.publication-statusPublished

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