Outcomes of surgical repair of complete atrioventricular canal defect in patients younger than 2 years of age

2岁以下患者完全性房室管缺损手术修复的预后

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Abstract

BACKGROUND: Early surgical management of complete atrioventricular (AV) canal defect is the optimal treatment option. Since the published evidence on outcomes is inconclusive, we retrospectively studied the outcomes of patients in our institution. OBJECTIVE: Study outcomes of complete AV canal repair. DESIGN: Retrospective, descriptive. SETTINGS: Single institute. PATIENTS AND METHODS: Medical records of patients under 2 years of age who underwent complete AV canal repair from January 2004 to December 2014 were retrospectively reviewed. MAIN OUTCOME MEASURES: Pre- and postoperative morbidity and mortality. SAMPLE SIZE: 140 patients. RESULT: The median (IQR) age at the time of surgery was 5.4 (3.9-8.2) months. Down syndrome was diagnosed in 98 (70%) of patients. AV valve regurgitation was found preoperatively in 129 (92%) and postoperatively in 135 (96%) patients. There was a significant association between preoperative pulmonary hypertension and the development of pulmonary hypertension in the postoperative period ( P=.04). Thirty-three patients needed reoperation. Arrhythmia was found in 19 patients, 16 of whom required pacemaker insertion. Seven patients died (5%). CONCLUSION: The presence of preoperative and postoperative AV valve regurgitation was common in this cohort but did not significantly affect patient survival. Our findings suggest an acceptable outcome for repair of complete AV septal defect with few complications postoperatively. LIMITATION: Retrospective in single institute. CONFLICT OF INTEREST: None.

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