The Anatolian Journal of Cardiology
Original Investigation - Pediatrics Heart Surgery

Long-term outcomes in patients who underwent surgical correction for atrioventricular septal defect

1.

Departments of Pediatric Cardiology and Başkent University İstanbul Health and Education Hospital; İstanbul-Turkey

2.

Departments of Pediatric Cardiology and Başkent University Ankara Hospital; Ankara-Turkey

3.

Departments of Cardiovascular Surgery, Başkent University Ankara Hospital; Ankara-Turkey

4.

Departments of Cardiovascular Surgery, Başkent University İstanbul Health and Education Hospital; İstanbul-Turkey

Anatol J Cardiol 2018; 20: 229-234
DOI: 10.14744/AnatolJCardiol.2018.39660
Read: 235 Downloads: 141 Published: 01 July 2021

Objective: The follow-up results of patients operated for atrioventricular septal defect (AVSD) during 1996–2016 at Başkent University are presented. Methods: Data obtained from hospital records consists of preoperative echocardiographic and angiographic details, age and weight at surgery, operative details, Down syndrome presence, postoperative care details, early postoperative and latest echocardiographic findings and hospitalization for reintervention. Results: A total of 496 patient-files were reviewed including 314 patients (63.4%) with complete and 181 (36.6%) with partial AVSD (48.4% of all patients had Down syndrome). Atrioventricular (AV) valve morphology was Rastelli type A in 92.2%, B in 6.5%, and C in 1.3% of patients. The operative technique used was single-patch in 21.6% (108), double-patch in 25.8% (128), and modified single-patch (Wilcox) in 52.5% (260) of patients. The follow-up time was 37.79±46.70 (range, 0–198) months. A total of 64 patients (12.9%) had arrhythmias while in the intensive care unit; pacemaker was implanted in 12 patients. A total of 78 patients (15.7%) were treated for pulmonary hypertensive crisis. The early morbidity and mortality in the postoperative first month were calculated as 38% and 10%, and the late morbidity and mortality (>1 month) were calculated as 13.1% and 1.9%, respectively. The rate of reoperation in our cohort was 8.9%. Conclusion: Although the early morbidity and mortality are low in AVSD operations, the rate of reoperations for left AV valve insufficiency are still high. Although Down syndrome is not a risk factor for early mortality, the co-morbid factors, such as longer postoperative mechanical ventilator or inotropic support, lead to higher risk for morbidity. The frequency of pulmonary hypertension and consequent complications are also high.

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ISSN 2149-2263 EISSN 2149-2271