Abstract
OBJECTIVE: To assess the results after repair of atrioventricular septal defect (AVSD) in adult patients in our centre. METHODS: We assessed 168 patients who received AVSD repair at a single institution from 2013 to 2023. Relevant data were obtained from medical and surgical records, and focused on the early and long-term results. RESULTS: Median age at surgery was 36.4 (27.0-47.8) years. One hundred and forty-seven patients (87.5%) with partial AVSD, 15 patients (8.9%) with intermediate AVSD and six patients (3.6%) with complete AVSD. Left atrioventricular valve (LAVV) regurgitation was present in 160 patients; the LAVV clefts were closed completely in 155 patients (92.3%), of which 36 (21.4%) underwent mitral valve ring annuloplasty and 18 (10.7%) patients underwent additional implantation of an incomplete flexible band into the LAVV. There were two early deaths, with two deaths over a median follow-up of 36.0 (14.0-60.0) months. According to the follow-up outcomes, the heart measurement, pulmonary artery pressure and valve regurgitations recovered significantly. A total of 34 patients underwent 37 reoperations. The majority of subsequent reoperations were performed because of residual LAVV pathology (n = 6, 16.2%), and arrhythmias (n = 31, 91.2%). Competing risks analysis revealed that 10 years after the initial operation, 2.6% had died without reintervention, 23.3% had received reintervention and 74.7% were alive without reintervention. CONCLUSIONS: AVSD in adult patients can be done safely with low early mortality and good long-term out-comes. While the reoperation rate is minimal, it is important to closely monitor the significant occurrence of arrhythmias.