[Atrioventricular discordance. Clinico-surgical experience 1990-2000]

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease
• Cardiac Surgery

Background:

• Atrioventricular discordance is a complex congenital heart defect.
• Understanding its variations and outcomes is crucial for surgical planning.

Purpose of the Study:

• To determine the incidence of ventriculoarterial connections with atrioventricular discordance.
• To identify associated cardiac lesions.
• To evaluate surgical results, including mortality and complications.

Main Methods:

• Retrospective analysis of patients diagnosed with atrioventricular discordance via echocardiography between 1990 and March 2000.
• Detailed review of patient demographics, cardiac anatomy, associated lesions, and surgical interventions.

Main Results:

• Thirty-six patients with atrioventricular discordance were identified, with ages ranging from infancy to adulthood.
• The most frequent ventriculoarterial connection was discordant (77.7%). Ventricular septal defects with pulmonary stenosis or atresia were common associated lesions (58%).
• Surgical interventions included palliative and corrective procedures, with one anatomical correction. High operative mortality (40.1%) and significant rates of postoperative atrioventricular block requiring pacemakers (40.1%) were observed.

Conclusions:

• Right ventricular dysfunction is a notable complication in patients with atrioventricular discordance.
• Surgical management of atrioventricular discordance is associated with high mortality and a substantial need for pacemakers due to atrioventricular block.