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Korean J Thorac Cardiovasc Surg 2009; 42(3): 299-304

Published online June 5, 2009

Copyright © Journal of Chest Surgery.

Surgical Treatment of Complete Atrioventricular Septal Defect:The Early and Mid-Term Results

Hyungtae Kim, M.D.*, Tae-Gook Jun, M.D.*, Ji-hyuk Yang, M.D.*, Pyo Won Park, M.D.*, Wook Sung Kim, M.D.*, Young Tak Lee, M.D.*, Kiick Sung, M.D.*

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Although the results of the surgical management for complete atrioventricular septal defect (c-AVSD) have improved, the optimal surgical strategy is still controversial. The aims of this study are to evaluate the outcome of c-AVSD repair and to define the risk factors related to reoperation. Material and Method: We retrospectively reviewed the medical records of 35 patients (8 males and 27 females) who underwent the total correction of c-AVSD from August 1996 to March 2008. The median age at repair was 5.2 months (range: 3 days∼82 months). Sixteen patients (45.7%) were associated with Down syndrome. Prior palliative operations were performed in 4 patients. The one-patch techniques were performed in 3 patients, and the two-patch techniques were done in 32 patients. Result: There was 1 early death (2.9%). The median follow-up period was 68 months (range: 2∼134 months) for 34 survivors. There was no late death. Reoperations were performed in 5 patients (14.3%) for severe left atrioventricular valvular regurgitation (AVVR). Nine patients (25.7%) showed left an AVVR of more than grade III. Associated major cardiac anomalies and the use of Gore-Tex patch for ventricular septal closure were the risk factors for postoperative left atrioventricular valve failure and reoperation. Conclusion: In this study, we found that surgical repair of c-AVSD was safe and effective. However, the high reoperation rate after repair remains a problem to be solved. (Korean J Thorac Cardiovasc Surg 2009;42:299-304)

Keywords: 1. Congenital heart disease (CHD), 2. Atrioventricular septal defect, 3. Atrioventricular valve insufficiency

Article

Original Article

Korean J Thorac Cardiovasc Surg 2009; 42(3): 299-304

Published online June 5, 2009

Copyright © Journal of Chest Surgery.

Surgical Treatment of Complete Atrioventricular Septal Defect:The Early and Mid-Term Results

Hyungtae Kim, M.D.*, Tae-Gook Jun, M.D.*, Ji-hyuk Yang, M.D.*, Pyo Won Park, M.D.*, Wook Sung Kim, M.D.*, Young Tak Lee, M.D.*, Kiick Sung, M.D.*

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Although the results of the surgical management for complete atrioventricular septal defect (c-AVSD) have improved, the optimal surgical strategy is still controversial. The aims of this study are to evaluate the outcome of c-AVSD repair and to define the risk factors related to reoperation. Material and Method: We retrospectively reviewed the medical records of 35 patients (8 males and 27 females) who underwent the total correction of c-AVSD from August 1996 to March 2008. The median age at repair was 5.2 months (range: 3 days∼82 months). Sixteen patients (45.7%) were associated with Down syndrome. Prior palliative operations were performed in 4 patients. The one-patch techniques were performed in 3 patients, and the two-patch techniques were done in 32 patients. Result: There was 1 early death (2.9%). The median follow-up period was 68 months (range: 2∼134 months) for 34 survivors. There was no late death. Reoperations were performed in 5 patients (14.3%) for severe left atrioventricular valvular regurgitation (AVVR). Nine patients (25.7%) showed left an AVVR of more than grade III. Associated major cardiac anomalies and the use of Gore-Tex patch for ventricular septal closure were the risk factors for postoperative left atrioventricular valve failure and reoperation. Conclusion: In this study, we found that surgical repair of c-AVSD was safe and effective. However, the high reoperation rate after repair remains a problem to be solved. (Korean J Thorac Cardiovasc Surg 2009;42:299-304)

Keywords: 1. Congenital heart disease (CHD), 2. Atrioventricular septal defect, 3. Atrioventricular valve insufficiency

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