Propensity score matched analysis of partial atrioventricular septal defect repair in infancy

Buratto, Edward; Daley, Michael; Ye, Xin Tao; Radford, Dorothy J.; Alphonso, Nelson; d’Udekem, Yves; Konstantinov, Igor E.

doi:10.1136/heartjnl-2017-312163

Cited by 15 publications

(22 citation statements)

References 13 publications

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“…Our group has recently performed a propensity score-matched analysis comparing children who underwent pAVSD repair in infancy, with those who underwent repair after 1 year of age 9. In a total of 75 infants, we observed an early mortality of 5.3% and long-term survival of 85% at 10 years, very similar to the results reported by Krupickova et al .…”

supporting

confidence: 86%

Repair of partial atrioventricular septal defects in infancy: a paradigm shift or a road block?

Konstantinov

Buratto²

2018

Heart

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supporting

confidence: 86%

Repair of partial atrioventricular septal defects in infancy: a paradigm shift or a road block?

Konstantinov

Buratto²

2018

Heart

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“…During the follow-up period, 4(8.7%) patients need reinterventions: 2 for permanent pacemaker implantation and 2 for recurrent severe mitral valve regurgitation. In published studies, the reoperation rates ranged around 10–15% [3, 4, 10, 11, 13]. The reoperation rate in this study was acceptable.…”

Section: Discussionmentioning

confidence: 44%

“…Partial atrioventricular canal defect repair is relatively mature now. In open heart surgery, the surgical procedures mainly encompass mitral valve cleft suture and primum atrial septal defect repair [3, 10, 11]. According to the reports, most patients only need the two procedures in surgery and the survival following surgeries revealed excellent results.…”

Section: Discussionmentioning

confidence: 99%

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Repair of partial atrioventricular canal defect in adult patients: two-year follow-up outcomes of a retrospective study

Song

2019

J Cardiothorac Surg

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Background Partial atrioventricular canal defects (PAVC) are preferred to be repaired when diagnosed and before an operation would interfere with school. There were rare previous studies about partial atrioventricular canal defect operations in adult patients. In this single-center retrospective study, we mean to review the mid-term follow-up outcomes of late diagnosed and repaired partial atrioventricular canal defects in adult patients. Methods 46 adult partial atrioventricular canal defect patients who underwent operation in West China Medical Center from 2009 to 2017 were included. Required data were obtained from operation notes, patient charts and the outpatient records. Results Among 46 patients, 10(21.7%)were male and mean age at operation was 37.6 ± 12.4 years. 11 patients had prior arrythmia, including 8 atrial fibrillations, 2 atrioventricular blocks and 1 left bundle branch block. There were 41 patients with tricuspid valve regurgitation and 22 underwent tricuspid valvuloplasty. All the patients had mitral regurgitation. 6 patients with valve incrassation and shrinkage underwent mitral valve replacement, and the rest underwent mitral repair surgery. There was one early death post operation and no more mortalities in the following follow-up years. According to the follow-up outcomes, heart function of the patients recovered significantly, dilation of atriums and ventricles, except for left atriums, were reversed to a large extent and all but one patients’ tricuspid valve regurgitations were reduced to mild and below. 4(8.7%) patients underwent reoperation and the main reasons were arrythmia and recurrent severe mitral valve regurgitation. Conclusion Partial atrioventricular canal defect repair in adult patients can achieve good results. Compared with the results of patients underwent operations in preschool years, though delayed surgery timing seems to bring more preoperative complications and influences heart function, the mortality and reoperation rate are excellent.

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“…Atrioventricular septal defect and transposition of the great arteries are both relatively common congenital cardiac malformations, with established techniques for achieving anatomical repair with good outcomes. [1][2][3][4][5][6][7] The association of the two conditions is very uncommon. In a large series of 507 cadaveric hearts with atrioventricular septal defect, only 3.4% (17/507) had transposition of the great arteries.…”

Section: Discussionmentioning

confidence: 99%

Single-ventricle palliation in children with atrioventricular septal defect and transposition of the great arteries: 45 years of experience

Buratto

Fricke

et al. 2020

Cardiol Young

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Background: The association of atrioventricular septal defect and transposition of the great arteries is very rare. As a rule, these patients have unbalanced ventricles. However, there have been no studies describing the results of single-ventricle palliation in these children. Methods: All children who underwent surgery with a diagnosis of atrioventricular septal defect and transposition of the great arteries were included in the study. Data were obtained from medical records. Results: A total of 38 patients with atrioventricular septal defect and transposition of the great arteries underwent single-ventricle palliation at the study institution between 1971 and 2016. The mean follow-up was 12.4 years (median: 14.6 years, range 2–43.3 years). Most children had unbalanced atrioventricular septal defect (94.7%, 36/38). Survival was 67.6% (95% confidence interval [CI]: 50.0–80.2%) at 10 years and 57.8% (95% CI: 38.0–73.4%) at 20 years. By 10 years, 58.6% (95% CI: 40.8–72.7%) had progressed to Fontan completion, while 32.5% (95% CI: 18.2–47.6%) had died. In patients achieving Fontan completion, 20-year event-free survival was 73.3% (95% CI: 34.8–91.3%), while 5.0% (95% CI: 0.4–20.5%) had undergone cardiac transplantation and 21.7% (95% CI: 3.2–50.8%) had undergone takedown of the Fontan circulation. Freedom from atrioventricular valve surgery was 57.0% (95% CI: 37.2–72.7%) at 10 and 20 years. Conclusions: The association of atrioventricular septal defect and transposition of the great arteries is very rare, and most of these children have unbalanced ventricles. Single-ventricle palliation results in 25-year overall survival of 50%. However, in patients, who had Fontan completion, survival was 75% at 25 years after Fontan operation.

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Propensity score matched analysis of partial atrioventricular septal defect repair in infancy

Abstract: Despite matching for risk factors, survival after repair of pAVSD during infancy is lower than that when repair is performed in older children, with no difference in reoperation rates. This suggests that elective repair of pAVSD should be deferred until after infancy.

Cited by 15 publications

References 13 publications

Repair of partial atrioventricular septal defects in infancy: a paradigm shift or a road block?

Repair of partial atrioventricular septal defects in infancy: a paradigm shift or a road block?

Repair of partial atrioventricular canal defect in adult patients: two-year follow-up outcomes of a retrospective study

Single-ventricle palliation in children with atrioventricular septal defect and transposition of the great arteries: 45 years of experience

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