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

Abstract

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.

Gradually Progressive Dyspnea and Exercise Intolerance in an Otherwise Active Middle-Aged Woman: Why Was the Presentation of Congenital Heart Disease Delayed?

“…11 Other studies demonstrated that follow-up of patients aged 40 years and older who had undergone surgical repair of partial AV canal defect indicated very favorable long-term survival. [12][13][14] Long-term mortality is substantial when AV canal defect is untreated, as only 25% of patients with AV canal defect survive beyond the age of 40 years without surgical intervention. 6 Indeed, the predicted annual mortality of partial AV canal defect in patients more than 50 years of age was estimated as 7.5%.…”

Incidentally detected atrioventricular septal defect in an adult

“…Intermediate AVSD is anatomically characterized by the presence of an ostium primum atrial septal defect occupying the portion of the atrial septum just superior to the individually formed RAVV and LAVV, and varying degrees of splitting of the anterior leaflet of the LAVV. 1,3 Intermediate-type AVSD is less frequent than complete or partial AVSD and is rarely encountered in adulthood. 4 Complete AVSD presents early in life, and unless treated, it expediently develops into irreversible pulmonary vascular disease.…”

“…AVSDs account for about 7%–17% of all congenital heart diseases. 1 Most patients undergo surgery during childhood, with favorable long‐term survival, although a few patients with incomplete AVSDs are not diagnosed until adulthood. It has been suggested that delayed surgery increases the incidence of preoperative complications and influences cardiac function.…”

Incidentally Detected Atrioventricular Septal Defect in an Adult

“…Comment is classified into four groups: complete, partial with an isolated primum ASD, partial with an isolated inlet VSD and intermediate type. Intermediate AVSD is anatomically characterized by the presence of an ostium primum atrial septal defect occupying the portion of the atrial septum just superior to the separately formed RAVV and LAVV, and varying degrees of clefting of the anterior leaflet of the LAVV [1,3]. Intermediate type AVSD is less frequent than complete or partial AVSD, and is tartly encountered in the adulthood [4].…”

“…Atrioventricular septal defect is a group of diverse malformations unified by having the same characteristic morphology at their atrioventricular septal junction. It account for about 7-17% of congenital heart disease [1]. Most patients undergo operation in childhood and the long-term survival after operation is favorable.…”