ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Long-term outcomes in patients who underwent surgical correction for atrioventricular septal defect [Anatol J Cardiol]
Anatol J Cardiol. 2018; 20(4): 229-234 | DOI: 10.14744/AnatolJCardiol.2018.39660

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

Özlem Sarısoy1, Canan Ayabakan1, Kürşad Tokel2, Murat Özkan3, Rıza Türköz4, Saıt Aşlamaci3
1Department of Pediatric Cardiology, Başkent University İstanbul Health and Education Hospital; İstanbul-Turkey
2Department of Cardiovascular Surgery, Başkent University İstanbul Health and Education Hospital; İstanbul-Turkey
3Department of Pediatric Cardiology, Başkent University Ankara Hospital; Ankara-Turkey
4Department of Cardiovascular Surgery, Başkent University Ankara Hospital; Ankara-Turkey

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.

Keywords: complete AVSD, partial AVSD, Down syndrome, single-patch technique, double-patch technique, Wilcox technique

Özlem Sarısoy, Canan Ayabakan, Kürşad Tokel, Murat Özkan, Rıza Türköz, Saıt Aşlamaci. Long-term outcomes in patients who underwent surgical correction for atrioventricular septal defect. Anatol J Cardiol. 2018; 20(4): 229-234

Corresponding Author: Özlem Sarısoy, Türkiye
Manuscript Language: English


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