Complete Atrioventricular Septal Defect: Evolution of Results in a Single Center During 50 Years
Riku Airaksinen1, Ilkka Mattila1, Eero Jokinen2
1Department of Pediatric Cardiac Surgery, New Children's Hospital, Helsinki University, Helsinki, Finland.
The Annals of Thoracic Surgery
|February 17, 2019
Summary
Surgical repair of complete atrioventricular septal defect (cAVSD) has seen significant improvements in operative mortality over time. However, late mortality and reoperation rates remain a concern, particularly in the early postoperative period.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease Research
Background:
- Complete atrioventricular septal defect (cAVSD) repair outcomes have improved, but late mortality and reoperation rates require further investigation.
- A lack of comprehensive, population-based studies exists on the evolving surgical results for cAVSD.
- Surgical techniques for cAVSD have remained consistent, yet outcomes have changed over time.
Purpose of the Study:
- To analyze the historical trends and progress in operative results for complete atrioventricular septal defect (cAVSD) repair.
- To evaluate changes in mortality and reoperation rates over several decades.
- To identify factors influencing long-term outcomes after cAVSD surgery.
Main Methods:
- A retrospective population-based study of 388 cAVSD patients operated between 1962 and 2014 in Finland.
- Data sourced from the Children's Cardiac Surgical Registry.
- Mortality and reoperation rates analyzed decade-by-decade.
Main Results:
- Operative mortality for cAVSD repair decreased significantly over decades, reaching zero in the most recent period.
- Late mortality occurred in 23 patients, with 20 heart-related deaths, half within the first postoperative year.
- Reoperation rates did not decrease and were concentrated in the first year post-surgery; 15-year freedom from atrioventricular valve reoperation was 90.9%.
Conclusions:
- Surgical outcomes for cAVSD have markedly improved over time, despite a consistent operative approach.
- Reoperation rates have not declined but are predominantly required in early childhood.
- Continuous improvement in surgical results for cAVSD is evident.
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