Surgical outcomes in the treatment of children with atrioventricular septal defects

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MahmodAbdalla-2008-08-27.pdf (1.33 MB)

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2008

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DOI:
http://dx.doi.org/10.22029/jlupub-13341

Abstract

Objective: We analyzed retrospectively the preoperative, operative, and postoperative events and their effect on surgical outcomes in patients with atrioventricular septal defect (AVSD). Methods: Between 1997 and 2007, 110 patients underwent surgical repair of atrioventricular septal defect, only 10 patients had previously palliative procedures. The median age at operation was 7.2 months (3 months- 19.8 years). Twenty- Five patients with unbalanced left ventricle (22.7%), and 74 patients with Down syndrome (67.3%). Two- patch technique was used in 81 patients (73.6%), including 6 patients with RVOTO, while single- patch technique in 29 patients (26.4%). Results: Five patients underwent early postoperative revision (4.6%). Four of these were due to severe mitral insufficiency, and one due to sub-aortic obstruction. Six patients required pacemaker implantation (5.7%), including 4 patients operated with 2-patch technique (5%) and 2 patients with single- patch technique (6.9%). Only 1 patient with Down syndrome had postoperatively complete AV block (1.4%). In the follow-up period 93.3% of patients had sinus rhythm. Early mortality was 1 patient (0.9%), due to severe mitral valve regurgitation and right heart failure. There was no late mortality. The follow- up was complete for 105 patients (96.3%), the mean follow-up time was 3.5 years ± 3.2 years. Twenty- Nine reoperations in 22 patients (20.1%) were performed (6 mitral valve replacements, 12 mitral valve repairs, 7 left ventricular outflow obstruction repairs, 1 VSD occluder implantation, 1 PDA closure by coils and 2 heart transplantations). Conclusions: Our data show that the biventricular surgical repair of atrioventricular septal defects can be performed with good outcomes, a low mortality rate and primary repair is the treatment of choice and can be accomplished with good results.

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