Repair of Partial and Transitional Atrioventricular Septal Defects: Mid-term Outcomes in a Single-center Cohort
Zewen Chen1, Yifan Li2, Wen Xie3
1Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China.
Insights
Surgical repair of atrioventricular septal defects (AVSDs) shows excellent mid-term survival and low reoperation rates in pediatric and adult patients. Refined atrioventricular valve repair strategies are crucial for reducing reinterventions.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Atrioventricular septal defects (AVSDs) are complex congenital heart conditions.
- Surgical repair aims for optimal outcomes and minimal reintervention.
- Evaluating mid-term results of AVSD repair in diverse age groups is critical.
Purpose of the Study:
- To assess the mid-term outcomes of surgical repair for partial and transitional atrioventricular septal defects (AVSDs).
- To compare outcomes between pediatric and adult patient populations.
- To analyze reoperation rates and atrioventricular valve (AVV) repair strategies.
Main Methods:
- Retrospective review of 136 patients undergoing partial or transitional AVSD repair (Jan 2019 - Dec 2022).
- Assessment of mortality, reoperation, and AVV repair strategies.
- Follow-up included evaluation of left atrioventricular valve (LAVV) regurgitation.
Main Results:
- No early or late deaths occurred in 136 patients (median follow-up 50.5 months).
- A low reoperation rate of 2.9% was observed, primarily for LAVV issues.
- Reoperation rates and LAVV regurgitation did not significantly differ by AVSD subtype, age, or annuloplasty type.
Conclusions:
- Surgical repair of partial and transitional AVSDs yields excellent mid-term survival and low reoperation rates.
- Refinement of AVV repair is essential to minimize LAVV reintervention and prevent outflow tract obstruction.
- Long-term follow-up is necessary to assess the durability of annuloplasty techniques.
Background:
Surgical repair of partial and transitional atrioventricular septal defects (AVSDs) aims to achieve optimal outcomes with minimal need for reintervention. This study aimed to evaluate the mid-term outcomes of AVSD repair in both pediatric and adult populations.
Methods:
We retrospectively reviewed all patients who underwent surgical repair for partial or transitional AVSDs at our center between January 2019 and December 2022. Key outcomes, including mortality, reoperation, and atrioventricular valve (AVV) repair strategies, were assessed during follow-up.
Results:
A total of 136 patients were included (partial AVSD, n = 100; transitional AVSD, n = 36), with a median follow-up of 50.5 months. The median hospital stay was 14 days. No early or late deaths occurred. Reoperation was required in four patients (2.9%); all reoperations included left atrioventricular valve (LAVV) reoperation. However, reoperation rates did not differ significantly between AVSD subtypes (p = 1.000) or age groups (p = 0.177). The incidence of moderate or greater LAVV regurgitation showed no significant difference between patients with and without ring annuloplasty, either postoperatively or at the final follow-up (both p = 1.000).
Conclusions:
Surgical repair of partial and transitional AVSDs results in excellent mid-term survival and a low reoperation rate across both pediatric and adult patients. Continued refinement of AVV repair strategies remains essential to reduce the risk of LAVV reintervention and prevent left ventricular outflow tract obstruction. Long-term follow-up is warranted to improve the evaluation of the durability of techniques such as suture annuloplasty and ring annuloplasty.
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