Korean J Thorac Cardiovasc Surg.  2001 Apr;34(4):311-321.

Long - term Surgical Result for Complete Atrioventricular Septal Defects

• Kim SH
• Park YH
• Song SW
• Cho BK

Abstract

Background :The purpose of this study was to evaluate the long-term surgical result and to analysis the risk factors associated postoperative death and residual left atrioventricular valve regurgitation after surgical repair of complete atrioventricular septal defect. MATERIAL AND METHOD: Case histories of the patients with atrioventricular septal defect presenting to our institution between July 1989 and June 2000 were reviewed. Seventy consecutive patients(M:36, F:34, age range, 1 month to 19 years, mean body weight 8.9+/-6.6 kg) underwent primary intracardiac repair of complete atrioventricular septal defect. Down syndrome was present in 39(55.7%). The 42 valves were postoperatively classified as Rastelli type A(60.0%), 6 type B(8.6%), and 20 type C(28.6%) and 2 valves were not clearly classified.Median follow-up time was 45.3 months. RESULT: Operative mortality was 12.9%(9 patients). Operative mortality, however, decreased over the period of the study from 20.0% before 1996 to 7.7% during the recent 5 years. Residual left atrioventricular valve regurgitation(over grade III/IV) was present in 10 patients(14.3%). Five-year and ten-year survival rate was 79.4% and five-year and ten-year freedom from reoperation was 91.4%. Multivariate logistic regression analysis identified only residual left atrioventricular valve regurgitation(over grade III/IV) as risk factor (odds ratio=38.5, p=0.001) for postoperative death and the commissure repair of left atrioventricular valve after cleft repair(odds ratio=6.72, p=0.02) as risk factor for residual left atrioventricular valve regurgitation(over grade III/IV).
CONCLUSION
Repair of complete atrioventricular septal defect during the infancy and the early childhood has acceptable early mortality, long-term survival rate and a low incidence of reoperation. For postoperative good function of left trioventricular valve and improved survival rate, surgical method should be focused on the leakless repair of AV valve.

MeSH Terms

Body Weight
Down Syndrome
Follow-Up Studies
Freedom
Humans
Incidence
Logistic Models
Mortality
Reoperation
Risk Factors
Survival Rate