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Successful atrioventricular valve repair improves long-term outcomes in children with unbalanced atrioventricular

Edward Buratto1, Xin Tao Ye1, Christian P Brizard1

  • 1Department of Cardiothoracic Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.

The Journal of Thoracic and Cardiovascular Surgery
|July 27, 2017
PubMed

Insights

Atrioventricular valve surgery in children with unbalanced atrioventricular septal defect and single-ventricle physiology has high mortality and reoperation rates. Successful valve repair improves survival and reduces reoperation risk.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Atrioventricular valve regurgitation significantly impacts morbidity and mortality in unbalanced atrioventricular septal defects.
  • Outcomes of atrioventricular valve repair in this specific pediatric population with univentricular physiology are not well-documented.

Purpose of the Study:

  • To evaluate the outcomes of atrioventricular valve surgery in children with unbalanced atrioventricular septal defect and univentricular physiology.
  • To identify factors associated with mortality and reoperation after atrioventricular valve surgery in this cohort.

Main Methods:

  • Retrospective review of patients with unbalanced atrioventricular septal defect undergoing atrioventricular valve surgery.
  • Analysis of early and long-term outcomes, including mortality, transplantation, and reoperation rates.

Main Results:

  • 18.2% early mortality; 20-year freedom from death or transplantation was 53.3%.
  • Significant predischarge atrioventricular valve regurgitation, young age, and repair before stage II palliation were associated with death.
  • 20-year freedom from reoperation was 56.3%; moderate regurgitation at discharge increased reoperation risk.

Conclusions:

  • Atrioventricular valve surgery in this complex pediatric group carries substantial mortality and reoperation risks.
  • Successful atrioventricular valve repair is linked to improved survival and reduced need for reoperation.
Abstract

Keywords:
Fontanatrioventricular valvesingle-ventricle palliationunbalanced atrioventricular septal defect

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