Late left atrioventricular valve insufficiency after repair of partial atrioventricular septal defects: Anatomical and surgical determinants

Abbruzzese, Pietro A.; Napoleone, Alessandra; Bini, R; Annecchino, Francesco Paolo; Merlo, Maurizio; Parenzan, L

doi:10.1016/0003-4975(90)90366-e

Cited by 49 publications

(40 citation statements)

References 11 publications

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“…The overall survival of patients undergoing repair of a PAVSD has improved considerably over the last three decades [1,4]. Our experience confirms that a PAVSD can be repaired with a low operative (3%) and no late mortality.…”

Section: Discussionsupporting

confidence: 76%

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The left atrioventricular valve in partial atrioventricular septal defect: management strategy and surgical outcome

Al-Hay

Lincoln

Shore

et al. 2004

European Journal of Cardio-Thoracic Surgery

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The hypothesis that in the absence of preoperative LAVVR it is necessary to place sutures in the SC has not been proven. We consider that in addition to preoperative cross sectional echocardiographic assessment of LAVVR intraoperative evaluation of LAVV function allows discrimination between those valves where sutures to the septal commissure are necessary and those where the valve can be left undisturbed.

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Section: Discussionsupporting

confidence: 76%

“…Abbruzzese et al [4] reported that in the absence of regurgitation, the LAVV can be left untouched with minimal risk for the need for reoperation. Thus, none of 25 unsutured LAVV required reoperation in our series.…”

Section: Discussionmentioning

confidence: 98%

The left atrioventricular valve in partial atrioventricular septal defect: management strategy and surgical outcome

Al-Hay

Lincoln

Shore

et al. 2004

European Journal of Cardio-Thoracic Surgery

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“…Reoperations were necessary for serious left AV insufficiency in four patients and for thrombosis of left AV prosthesis in two. Abruzzese reported 18% of patients showing moderate to serious late left AV insufficiency, including 10% of patients who needed a reoperation, bearing in mind that within the series he did not suture the septal commissure in 31.1% of his patients [16]. Our results encourage a systematic suturing of the septal commissure [15].…”

Section: Late Resultssupporting

confidence: 48%

Atypical forms of isolated partial atrioventricular septal defect increase the risk of initial valve replacement and reoperation

Aubert¹,

Hénaine²,

Raisky³

et al. 2005

European Journal of Cardio-Thoracic Surgery

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The morbi-mortality of the isolated partial AV septal defect is primarily perioperative and is linked with the presence of an atypical form of the lesion. This atypical form was the main reason for reoperation for AV valve regurgitation. The AV valve replacement was associated with a high mortality and with the occurrence of complete AV block. Using a standardized technique, the AV septal defect can be repaired with excellent long-term clinical and echographic results.

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“…It has been recommended that the cleft be left untouched when it causes mild or no mitral regurgitation, on the basis that the cleft works as a commissure. 14 We do not agree the cleft works as a commissure, but sometimes it does not cause any valve insufficiency. Our protocol is to repair all clefts causing any degree of regurgitation; in this series, all patients had mild or significant mitral regurgitation.…”

Section: Discussionmentioning

confidence: 97%

“…It has been reported that preoperative left AV valve insufficiency is the most significant risk factor for late left AV valve insufficiency in patients with partial AVCD. 14 We showed that significant late mitral regurgitation was the only risk factor for reoperation. We try to repair the mitral valve at reoperation whenever possible, but we had to replaced it in one adult in whom the valve was thickened and not amenable to repair.…”

Section: Discussionmentioning

confidence: 98%

Mitral Clefts and Interatrial Septum Defects: 15-Year Results

Kırali

Mansuroğlu

Özen

et al. 2003

Asian Cardiovasc Thorac Ann

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Between 1985 and 2002, 60 patients (58% female) with a mean age of 20.3 +/- 12.1 years (range, 2-55 years) were treated for anterior mitral leaflet cleft. There was a primum atrial septal defect in 52 patients (87%) and a secundum type in 8 (13%). Concomitant cardiac defects were patent foramen ovale in 6 patients, cleft tricuspid valve in 3, ventricular septal defect in 2, cor triatriatum in 1, and persistent left superior vena cava in 1. Mean grade (1-4) of mitral insufficiency was 2.28 +/- 0.74. Atrial septal defects were closed with a pericardial patch in 45 patients, with a prosthetic patch in 11, and primarily in 4. Mitral leaflet clefts were repaired using interrupted sutures. There was no early or late mortality. Two patients (3%) needed a permanent pacemaker. Postoperatively, severe (> or =grade 3) mitral insufficiency developed in 2 patients; valve replacement was performed in one, cleft recurrence and leakage from the patch were treated in the other. Freedom from reoperation was 92.2% +/- 5.6% at 15 years. Surgical intervention can be performed for congenital anterior mitral leaflet cleft and interatrial septal defect with good results in both pediatric and adult age groups.

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Late left atrioventricular valve insufficiency after repair of partial atrioventricular septal defects: Anatomical and surgical determinants

Cited by 49 publications

References 11 publications

The left atrioventricular valve in partial atrioventricular septal defect: management strategy and surgical outcome

The left atrioventricular valve in partial atrioventricular septal defect: management strategy and surgical outcome

Atypical forms of isolated partial atrioventricular septal defect increase the risk of initial valve replacement and reoperation

Mitral Clefts and Interatrial Septum Defects: 15-Year Results

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