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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Published on: February 8, 2022

Partial and transitional atrioventricular septal defect outcomes.

L LuAnn Minich1, Andrew M Atz, Steven D Colan

  • 1University of Utah, Salt Lake City, Utah, USA. luann.minich@imail.org

The Annals of Thoracic Surgery
|January 28, 2010
PubMed
Summary
This summary is machine-generated.

Surgical repair of atrioventricular septal defects (AVSD) shows low mortality and short hospital stays. Early repair, especially in children aged 3-18 months, promotes catch-up growth, though left atrioventricular valve regurgitation can persist.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiovascular Outcomes Research

Background:

  • Advancements in surgical and perioperative care enable earlier repair of partial and transitional atrioventricular septal defects (AVSD).
  • Contemporary outcomes data are essential for guiding clinical practice and patient management.

Purpose of the Study:

  • To describe the contemporary outcomes of primary biventricular repair for partial or transitional AVSD in a multicenter cohort.
  • To evaluate short-term and mid-term postoperative results, including growth, valve function, and residual defects.

Main Methods:

  • Retrospective analysis of 87 patients undergoing primary biventricular repair of partial/transitional AVSD across seven North American centers (June 2004 - February 2006).
  • Collection of one-month and six-month postoperative data on weight-for-age z-scores, left atrioventricular valve regurgitation (LAVVR) grade, residual shunts, and left ventricular ejection fraction.
  • Paired statistical methods were employed to assess changes over the six-month follow-up period.

Main Results:

  • Median age at surgery was 1.8 years, with a median weight z-score of -0.88. Hospitalization was brief (median 5 days), with low in-hospital mortality (1 patient).
  • At six months, weight z-scores improved significantly (median 0.4 units, p < 0.001), particularly in underweight children under 18 months.
  • Left atrioventricular valve regurgitation (LAVVR) was the most common residual defect (31% at 6 months), occurring more frequently in patients repaired after 4 years of age.

Conclusions:

  • Primary biventricular repair of partial/transitional AVSD is associated with low morbidity and mortality, short hospital stays, and favorable growth outcomes.
  • Catch-up growth is particularly noted in underweight children undergoing repair between 3 and 18 months.
  • Left atrioventricular valve regurgitation remains a significant residual issue, with increased incidence in older children undergoing repair.