Repair for partial and complete atrioventricular septal defect: single centre experience and long-term results

Area of Science:

• Cardiology
• Congenital Heart Disease Surgery
• Adult Congenital Heart Disease

Background:

• Growing population of adults with surgically repaired congenital heart defects.
• Need to compare long-term outcomes of partial (pAVSD) vs. complete (cAVSD) atrioventricular septal defect repair.
• Identify primary drivers for re-intervention in these patient groups.

Purpose of the Study:

• Compare late outcomes between pAVSD and cAVSD surgical repair in adults.
• Determine the most significant reason for re-intervention after pAVSD and cAVSD repair.
• Evaluate long-term event-free survival in adult patients following AVSD repair.

Main Methods:

• Retrospective review of adult patients (>16 years) undergoing pAVSD or cAVSD repair.
• Descriptive statistics and Kaplan-Meier analysis for event-free survival.
• Log-rank testing to compare survival curves between pAVSD and cAVSD groups.

Main Results:

• 138 adult patients included; 138 patients (33/30 male/female, mean age 35.9 ± 15.6 years) in pAVSD group and 71 patients (27/44 male/female, mean age 25.7 ± 11.9 years) in cAVSD group after exclusions.
• 14 pAVSD patients and 23 cAVSD patients required re-intervention, primarily for mitral valve issues (2 vs. 13 repairs) or valve replacement (5 vs. 1 replacement).
• Median event-free survival was significantly longer for pAVSD (34.0 years) vs. cAVSD (22.9 years) (P=0.017); atrial arrhythmias and conduction disorders were noted in both groups.

Conclusions:

• Adult patients with pAVSD demonstrate superior long-term event-free survival compared to those with cAVSD.
• Mitral valve regurgitation is the leading cause for re-intervention in both pAVSD and cAVSD repair.
• Atrial arrhythmias and conduction disorders represent significant late complications following atrioventricular septal defect repair.