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Contemporary results after repair of partial and transitional atrioventricular septal defects
| Content Provider | Scilit |
|---|---|
| Author | Mery, Carlos M. Zea-Vera, Rodrigo Chacon-Portillo, Martin A. Zhang, Wei Binder, M. Scott Kyle, William B. Adachi, Iki Heinle, Jeffrey S. Fraser, Charles D. |
| Copyright Year | 2018 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery The exact incidence and risk factors for reoperation in partial and transitional atrioventricular septal defects (P/TAVSD) are unclear. The goal of this study was to assess risk factors for left atrioventricular valve (LAVV) and left ventricular outflow tract (LVOT) reoperation in P/TAVSD. All patients undergoing P/TAVSD repair between 1995-2017 were reviewed. Patients were classified as: infants (<1 year), toddlers (1-3 years), children (3-17 years), and adults (≥18 years). Survival and reoperation were assessed using log-rank test and Cox models for univariate and multivariable analysis, respectively. Overall, 265 patients underwent P/TAVSD repair (partial: 177[67%]). Median age was 2 years. The cohort included 73 (28%) infants, 85 (32%) toddlers, 94 (35%) children, and 13 (5%) adults. Trisomy 21 (T21) was present in 76 (29%) patients and in 216 (83%) the zone of apposition was completely closed. Perioperative mortality was 0.8%. No patient developed complete heart block. Ten-year survival and freedom-from-reoperation were 98% and 81%, respectively. On multivariable analysis, T21 (Hazard Ratio[HR]: 0.16) and older age compared to infants (toddlers: HR: 0.35; children: HR: 0.25), were protective for any reoperation, whereas heterotaxy (HR: 3.43) was a risk factor. For LAVV reoperation, toddlers (HR 0.35), children (HR 0.25) and T21 (HR 0.16) remained protective, while LAVV anomaly was a risk factor (HR: 2.61). Similarly, for LVOT reoperation, toddlers (HR 0.24) and children (HR 0.06) were protective. Mortality after P/TAVSD repair is minimal, yet, reoperation for LAVV disease and LVOT obstruction remains significant. Patients requiring repair during infancy are at higher risk of reoperation. |
| Related Links | http://www.jtcvs.org/article/S0022522318331465/pdf |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2018.10.154 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 3 |
| Volume Number | 157 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-11-24 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Cardiology and Cardiovascular Diseases Pediatrics and Child Health 95% Confidence Interval Atrial Septal Defect Atrioventricular Septal Defect Left Atrioventricular Valve Left Ventricular Outflow Tract Permanent Pacemaker Partial and Transitional Atrioventricular Septal Defect Ventricular Septal Defect |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
