Abstract 14490: Outcome of Symptomatic Partial Atrioventricular Septal Defect Requiring Repair During Infancy. Multicentric Study.
Introduction: Patients with symptomatic partial atrioventricular septal defect (pAVSD) requiring early surgical repair are thought to be at greater risk. However, the outcome and risk profile of this cohort of patients is currently poorly defined.
Hypothesis: The aim of this study was to investigate the outcome of symptomatic pAVSD infants requiring early repair and to identify risk factors which may predict mortality and left atrioventricular valve (LAVV) reoperation.
Methods: This multicenter study recruited 51 patients (24 female) in 3 tertiary centres. The inclusion criteria were: i) pAVSD (including cases with negligible ventricular component), ii) heart failure unresponsive to treatment, iii) biventricular repair during the first year of life. Medical notes and operative notes were retrospectively analysed for demographic, perioperative and echocardiographic data.
Results: The median age at the corrective surgery was 179 (range 0-357) days. Sixteen patients (31%) had unfavorable anatomy of the LAVV: dysplastic(N=7), double orifice(N=3), severely deficient valve leaflets (N=1), hypoplastic LAVV annulus and/or mural leaflet (N=3), short/poorly defined chords (N=2). Four patients (7.8%) died at median interval of 52 days (range 0-187 days) after primary repair. Eleven patients (22%) were re-operated at a median interval of 40 days following primary repair (4 days - 5.1 years) for severe LAVV regurgitation. Two patients required mechanical LAVV replacement. In multivariate analysis, the anatomy of the LAVV was the only risk factor associated with LAVV reoperation.
Conclusions: Patients with pAVSD requiring repair during infancy experience significant morbidity and mortality. Surgical repair is successful in the majority of the cases. The re-operation rate of the LAVV is high and the presence of unfavourable LAVV anatomy is an independent predictor of an adverse outcome.
Author Disclosures: S. Krupickova: None. G. Morgan: None. M. Cheang: None. O. Ghez: None. M. Rigby: None. A. Battista: None. A. Spanaki: None. R. Franklin: None. J. Marek: None. A. Fraisse: None.
- © 2016 by American Heart Association, Inc.