Surgical repair of partial atrioventricular septal defect

To review the results of surgical correction of partial atrioventricular septal defect and associated cardiac comorbidities.

Retrospective case analysis of electronic database of department of paediatrics cardiac surgery, CPEIC, Multan was done. Forty consecutive patients operated for partial atrioventricular septal defect repair from September 2011 to October 2016 were included. Mean age was 14.67±7.96 years. 60% (24) patients were male. Regarding echocardiographic findings, pre-operatively 40% (n=16) had mild, 47.5% (19) had moderate and 12.5% (n=5) had severe mitral valve regurgitation. There were 25% (n=10) patients having moderate tricuspid valve regurgitation. Pulmonary hypertension was moderate in 57.5% (n=23) cases and severe in 7.5% (n=3) cases. Among other associated lesions 10% (n=4) patients had secundum ASD, pulmonary artery stenosis was seen in 5% (n=2) patients. Another 5.0% (n=2) patients had bilateral SVCS. While one patient had PDA and one patient had associated common atrium.

Post-operatively there were 19 cases (47.5%) having no mitral valve regurgitation while 18 (45%) patients showed mild and 7.5% (n=3) had moderate mitral valve regurgitation. Only one case had moderate tricuspid valve regurgitation post-operatively, while 22.5% (n=9) cases had mild tricuspid regurgitation. Complete heart block and left sided brain infarct developed in one case. There was no mortality, reoperation, residual atrial shunt or left ventricular outflow tract obstruction.

Repair of partial AV canal carries good overall results with minimal mortality however earlier repair is suggested to reduce post- operative morbidity further.