Long-term outcome after early repair of complete atrioventricular septal defect in young infants

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Jens Johansson Ramgren1, Shahab Nozohoor2, Igor Zindovic2

  • 1Section for Pediatric Cardiac Surgery, Department of Pediatrics, Lund University and Children's Hospital, Skane University Hospital, Lund, Sweden.

The Journal of Thoracic and Cardiovascular Surgery
|September 13, 2020
PubMed

Insights

Early repair of complete atrioventricular septal defect offers excellent survival rates and low reoperation needs. Primary correction in infants under 3 months is well-tolerated, avoiding palliative procedures.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiovascular Outcomes Research

Background:

  • The long-term outcomes following surgical repair of complete atrioventricular septal defect (CAVSD) in young infants remain incompletely understood.
  • Assessing survival and identifying risk factors for left atrioventricular valve-related reoperations is crucial for optimizing patient care.

Purpose of the Study:

  • To evaluate long-term survival and identify risk factors for left atrioventricular valve-related reoperations after CAVSD repair.
  • To compare outcomes between young infants (<3 months) and older infants (>3 months) undergoing CAVSD repair.

Main Methods:

  • A retrospective analysis of 304 consecutive patients who underwent surgical correction for CAVSD between April 1993 and October 2018.
  • Comparison of outcomes between young infants (n=55) and older infants (n=249).
  • Kaplan-Meier method used to assess overall survival and freedom from left atrioventricular valve-related reoperation over a mean follow-up of 13.2 years.

Main Results:

  • Overall 30-day mortality was 1.0% with no significant difference between age groups.
  • Twenty-year overall survival was 95.1%. Independent risk factors for poor survival included additional ventricular septal defect, coarctation of the aorta, persistent left superior vena cava, and non-Trisomy 21 genetic syndromes.
  • Twenty-year freedom from left atrioventricular valve-related reoperation was 92.6%, with no significant difference between young and older infants.

Conclusions:

  • Excellent long-term survival and a low incidence of reoperations due to left atrioventricular valve regurgitation can be achieved with early CAVSD repair.
  • Primary surgical correction in infants younger than 3 months is well-tolerated when clinically indicated, potentially avoiding palliative interventions.
Abstract

Keywords:
complete atrioventricular septal defectcongenitalheart surgery

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