Published in:
01-12-2013 | Original Article
Early and midterm outcome of complete Atrioventricular Septal Defect (AVSD) in a single institution
Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Issue 4/2013
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Background
Surgical repair of complete atrioventricular septal defect is a well established procedure performed in young children. We sought to determine the rate of survival, reoperation and occurrence of Left Atrioventricular Valve Regurgitation (LAVVR).
Patients and methods
This was a retrospective review of 56 patients with Complete Atrioventricular Septal Defect (CAVSD) recruited from January 2000 till July 2010. Sixty-six percent of these patients had Down’s Syndrome. The median age and weight at surgery was 0.95 ± 2.7 years and 6.2 ± 7.5 kg respectively. 2D Echocardiography was used to quantify the degree of LAVVR pre and postoperatively. The technique of repair used was either 2 patch, modified single patch or single patch. The cleft in the LAVV was closed in all cases. Risk factors associated with increased mortality and re-intervention were analyzed.
Results
The operative mortality was 5.4 %. There were 3 patients who developed complete heart block and required Permanent Pace Maker (PPM) implantation whereas 11 patients (20 %) developed supraventricular arrhythmia. Twenty-one percent of patients had moderate LAVVR at discharge. Eight patients (14 %) required re-operation for LAVV regurgitation at a mean duration of 17 ± 29 months. The mean ICU stay was 6 days. Prolonged ventilation and presence of infection trended towards higher mortality. The presence of moderate or severe LAVVR at discharge was one of the main factors for re-intervention.
Conclusion
The surgical repair of Complete Atrioventricular Septal Defect in young children is associated with acceptable mortality and morbidity. Left atrio-ventricular valve regurgitation remains the most common residual defect and significantly associated with re-intervention.