Repair of complete atrioventricular septal defect with tetralogy of Fallot

Cardiac Function After Tetralogy of Fallot/Complete Atrioventricular Canal Repair

“…Our perioperative mortality of 0% compares favorably to reported mortalities of 0% to 31%. 4,[6][7][8][9][10][11][12][13][14] Similarly, our 0% late mortality is consistent with certain small series that have also reported no late mortalities, 4,10 though other series have reported up to 6% to 14% late mortality over approximately five years of follow-up. 6,11,12 In two series of longer durations, Table 3.…”

“…11,12 Some studies of 7 to 10 years of follow-up have reported 15% to 46%, 6,7,9 and in one study of 17-year follow-up, the reoperation rate was 30%. 8 In some studies, the predominant indication for reoperation was LAVVR, 4,7,8,12 whereas in others RVOT pathology was the most likely residual issue requiring repeat surgery. 9 In some studies where LAVVR formed the majority of indications for reoperation, RVOT also constituted a substantial number, supporting the importance of RVOT pathology and LAVVR as long-term concerns in this population.…”

“…Although initially management of these patients favored palliation followed by complete repair, over the past several decades the strategy has changed to complete repair in infancy. Studies of these patients have largely been limited to small case series from single institutions focusing on perioperative outcomes 4,5 or longer-term outcomes including mortality and need for reoperation. [6][7][8][9] However, midterm functional results, with the assessment of residual obstruction as well as valvar and ventricular functions, have not been the focus of previous studies.…”

Short to medium term outcomes of right ventricular outflow tract stenting as initial palliation for symptomatic infants with complete atrioventricular septal defect with associated tetralogy of Fallot

“…3 Further justification for a delayed repair was the relief of RVOT obstruction without the need for a transannular patch (TAP) or the use of a larger valved conduit, reducing the burden of post-operative pulmonary valve (PV) regurgitation. 3,8 It was thought that substantial pulmonary regurgitation (PR) would volume load the right ventricle and exacerbate AVV regurgitation.…”

“…9 RVOT stenting has evolved into a credible alternative to systemic-to-pulmonary artery shunting in symptomatic infants with tetralogy of Fallot and reports have demonstrated superiority compared to mBTTS with regards to pulmonary artery growth. [8][9][10] We present the combined experience from two large tertiary referral centres with RVOT stenting in cAVSD/TOF with particular emphasis on short-and medium-term outcomes.…”