Complete atrioventricular septal defects: the influence of associated cardiac anomalies on surgical management and outcome
| Autor: | John G.C. Wright, John M Redmond, Babulal Sethia, William J. Brawn, E. D. Silove, J V De Giovanni, Narayanswami Sreeram |
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| Rok vydání: | 1996 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Reoperation medicine.medical_specialty Heart disease Treatment outcome Aorta Thoracic Pulmonary Artery Aortic Coarctation medicine.artery Hypoplastic Left Heart Syndrome medicine Methods Humans Atrioventricular Septal Defect Atrioventricular cushions Child Survival rate Retrospective Studies Aorta business.industry Infant Retrospective cohort study General Medicine medicine.disease Double Outlet Right Ventricle Surgery Survival Rate Treatment Outcome Child Preschool Tetralogy of Fallot Female Congenital disease Down Syndrome Cardiology and Cardiovascular Medicine business Endocardial Cushion Defects |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 10(11) |
| ISSN: | 1010-7940 |
| Popis: | Major associated cardiac anomalies are known to increase the risk of repair of complete atrioventricular septal defects (CAVSDs). The purpose of this study was to examine the effects of such anomalies on the current surgical management of CAVSDs and their influence on outcome following repair.We performed a retrospective review of a 100 consecutive non-isomeric patients undergoing repair of CAVSD at our institution, between January 1989 and December 1994; patients with partial or intermediate defects were excluded. Complete atrioventricular septal defect patients with other major cardiac abnormalities (complex) were then compared to those with isolated CAVSDs.There were 15 patients (15%) with associated anomalies; 3 had tetralogy of Fallot, 1 patient had pulmonary atresia, 6 had hypoplastic left or right ventricle, 1 had tetralogy of Fallot and hyperplastic right ventricle, 2 patients had double outlet right ventricle, 1 had hypoplastic aortic arch and 1 patient had aortic coarctation. The median age at operation was similar for both groups (4.2 months), while the median weight was not significantly different for isolated CAVSDs compared to complex (4.2 months vs 3.4 months, P = 0.89), but there was a higher incidence of trisomy 21 (70/85, 82% vs 8/15, 53.3%, P = 0.01). Two of the 85 isolated CAVSD patients (2.3%) had undergone palliative pulmonary artery banding, while 5 of the 15 complex patients (33.3%) had either banding or Blalock-Taussig shunts performed. The technique of CAVSD repair was identical in each group. All complex patients had standard repair of their associated anomalies. Hospital mortality was higher in the complex group (3/15, 20% vs 2/85, 2.3%, P = 0.004); all early deaths in the complex group occurred in patients with a hypoplastic ventricle. Reoperation for left atrioventricular valve regurgitation was required in six isolated CAVSD patients (7.1%) and in one complex (6.6%).In the absence of significant ventricular hypoplasia, the early results of surgical repair in patients with CAVSDs and associated cardiovascular anomalies are similar to those achieved in patients with isolated CAVSD. |
| Databáze: | OpenAIRE |
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