Early Outcomes for Management of Atrioventricular Septal Defect-Tetralogy of Fallot in the Last Decade: A Congenital Heart Surgeons' Society Study.
| Autor: | Callahan CP; Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA., Argo MB; Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, USA.; Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada., McCrindle BW; Pediatric Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada., Barron DJ; Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada., Jegatheeswaran A; Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children, London, UK.; Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK., Honjo O; Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada., Polimenakos AC; Division of Pediatric and Congenital Cardiac Surgery, Children's Hospital of Georgia, Augusta, GA, USA., Turek JW; Department of Surgery, Duke Children's Hospital, Durham, NC, USA., Dabal RJ; Division of Cardiothoracic Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA., Kirklin JK; Division of Cardiothoracic Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA., DeCampli WM; Division of Pediatric Cardiac Surgery, Arnold Palmer Hospital for Children, Orlando, FL, USA., Eghtesady P; Division of Pediatric Cardiothoracic Surgery, St. Louis Children's Hospital, St. Louis, MO, USA., Overman DM; Division of Cardiovascular Surgery, Children's Hospital and Clinics of Minnesota, Minneapolis, MN, USA. |
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| Jazyk: | angličtina |
| Zdroj: | World journal for pediatric & congenital heart surgery [World J Pediatr Congenit Heart Surg] 2024 Nov 21, pp. 21501351241293158. Date of Electronic Publication: 2024 Nov 21. |
| DOI: | 10.1177/21501351241293158 |
| Abstrakt: | Background: We sought to determine the management and early outcomes of complete atrioventricular septal defect-tetralogy of Fallot (AVSD-TOF) for a contemporary multicenter cohort. Methods: Of 739 participants in the Congenital Heart Surgeons' Society AVSD cohort (January 2012-May 2021), 40 had AVSD-TOF. We first compared survival differences for patients with AVSD-TOF versus those with isolated AVSD using propensity matching. Secondly, for patients with AVSD-TOF, we compared staged (n = 16) versus primary (n = 24) repair by assessing the following: patient characteristics, progression of atrioventricular valve (AVV) regurgitation, and time-related reoperation and survival. Results: Five-year survival was similar between matched AVSD-TOF and isolated AVSD groups (80% vs 81%, P = .9). Compared with primary repair patients, staged patients had smaller pulmonary valve annulus Z-score measured at first presentation (-2.2 vs -2.9, P = .006). All staged patients (12 Blalock-Thomas-Taussig shunts, 3 right-ventricular-outflow-tract stents, 1 ductal stent) survived to complete repair. Freedom from AVSD-related reoperation five years post-AVSD-TOF repair was 57% after staged versus 90% after primary repair ( P < .05) and left AVV reoperations were the most frequent reintervention. Survival five years after AVSD-TOF repair was 80% (63% after staged vs 90% after primary repair; P = .08). Conclusions: Patients undergoing AVSD-TOF repair have similar survival compared with matched isolated AVSD patients. Although approximately half of AVSD-TOF patients had initial palliation and all survived to complete repair, staged repair patients had lower survival and a higher reintervention rate compared with primary repair patients. The decision to pursue staged versus primary repair for future babies with AVSD-TOF remains challenging and should be chosen based on individual circumstances. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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