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https://hdl.handle.net/2440/98583
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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 1873-734X |
Statement of Responsibility: | 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. |
DOI: | 10.1093/ejcts/ezt444 |
Published version: | http://dx.doi.org/10.1093/ejcts/ezt444 |
Appears in Collections: | Aurora harvest 3 Paediatrics publications |
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