Surgical Outcome of Reoperation Due to Left Atrioventricular Valve Regurgitation After Previous Correction of Complete Atrioventricular Septal Defect

Prifti, Edvin; Bonacchi, Massimo; Baboci, Arben; Giunti, Guido; Krakulli, Klodian; Vanini, Vittorio

doi:10.1111/jocs.12231

Cited by 16 publications

(16 citation statements)

References 20 publications

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“…Different recent studies have reported a re-operation rate between 6.8% and 11% in patients with CAVSD undergoing twopatch or single patch technique correction (22). Other reported CAVSD series including both techniques failed to demonstrate statistically the single-patch technique as a possible predictor for early and late re-operation (1,22). Dividing the anterior bridging leaflet, affords an improved view of the margins of the defect, identifying carefully the true extent of the VSD through the atrium.…”

Section: The Management Of the Rvotmentioning

confidence: 99%

Repair of complete atrioventricular septal defect with tetralogy of Fallot

Prifti¹

2017

Transl. Pediatr.

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Section: The Management Of the Rvotmentioning

confidence: 99%

Repair of complete atrioventricular septal defect with tetralogy of Fallot

Prifti¹

2017

Transl. Pediatr.

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“…This impairment not only increases the risk of "reoperation", but also can increase the mortality rate and even the cost of hospitalization, by hemodynamic impairment [14,[27][28][29]. In addition, AVSD reveals a wide range of heart and non-cardiac diseases, so it requires careful preoperative examination and multiple surgical procedures with different treatment options.…”

Section: Issn 0970-938x Wwwbiomedresinfomentioning

confidence: 99%

Surgical outcome of atrioventricular septal defect: A 10 years review

Omrani¹,

Hashemzadeh²

2018

biomedicalresearch

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Background: Surgical management of patients with Atrioventricular Septal Defect (AVSD) has advanced over the last decades. The aims of this study were to evaluate the early and late outcomes in patients undergoing operation at a single heart center. Methods: Between April 2006 and April 2016, 337 consecutive patients underwent Atrioventricular Septal Defect (AVSD) repair at the Shaheed Rajaie Heart Center. The patients were subtyped as 73 (21.7%) partial, 67 (19.9%) transitional and 197 (58.5%) complete. Results: At the time of preoperative evaluation, there were 39 cases (11.7%) with moderate to severe or severe Left Atrioventricular Valve Regurgitation (LAVVR). Previous Pulmonary Artery banding (PA banding) had been performed in 144 (42.7%) patients and associated malformations were found in 115 (34.1%). Type of surgical repair was single patch 193 (57.3%), double patch 144 (42.7%), and single atrial septal defect patch with primary ventricular septal defect closure in TAVSD 64 (95.5%). 141 patients (71.6%) with CAVSD underwent definitive early repair by using a two patch technique and complete cleft closure. Annuloplasty and/or commissuroplasty were performed for 60 (17.8%) patients and debanding was also implemented in all patients. Mean hours for ventilation were determined as 26.8 ± 2.8. Mean days for intensive care unit was defined to be 4.4 ± 0.2, and total hospitalization time was as 26.8 ± 0.5. A 1 month, 21.9% (72 of 328) had ejection fraction less than 55%; 33 (10.9%) had more than moderate LAVVR; 73 (24.2%) had residual Ventricular Septal Defect (VSD), followed by 14 cases (4.6%) with residual Atrial Septal Defect (ASD) and 2 cases (0.6%) with Left Ventricular Outlet Tract Obstruction (LVOTO). Conclusions: Definitive early repair for AVSD can be performed with acceptable results. Despite a complete cleft closure, LAVVR remains the most common residual defect that more frequently required reoperation in the future.

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“…In North America and Europe, between 9% and 17% of patients with complete atrioventricular septal defect (AVSD) are discharged home with significant residual left atrioventricular valve regurgitation (LAVVR) after definitive surgical repair, even with intraoperative monitoring by transesophageal echocardiography [ 1 , 2 ] . Aside from the obvious risk of reoperation that it implies, the presence of LAVVR with hemodynamic compromise in this period may increase length of hospital stay, morbidity and mortality, and it may also increase costs [ 1 - 6 ] .…”

Section: Introductionmentioning

confidence: 99%

Left Atrioventricular Valve Regurgitation After Repair of Complete Atrioventricular Septal Defect

Kozak¹,

Kozak²,

Marchi³

et al. 2015

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionLeft atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defects.ObjectiveTo determine factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of surgical repair of complete atrioventricular septal defect.MethodsWe assessed the results of 53 consecutive patients 3 years-old and younger presenting with complete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. Median age was 6.7 months; median weight was 5.3 Kg; 86.8% had Down syndrome. At the time of preoperative evaluation, there were 26 cases with moderate or severe left atrioventricular valve regurgitation (49.1%). Abnormalities on the left atrioventricular valve were found in 11.3%; annuloplasty was performed in 34% of the patients.ResultsAt the time of postoperative evaluation, there were 21 cases with moderate or severe left atrioventricular valve regurgitation (39.6%). After performing a multivariate analysis, the only significant factor associated with moderate or severe left atrioventricular valve regurgitation was the absence of Down syndrome (P=0.03).ConclusionAbsence of Down syndrome was associated with moderate or severe postoperative left atrioventricular valve regurgitation after surgical repair of complete atrioventricular septal defect at our practice.

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Surgical Outcome of Reoperation Due to Left Atrioventricular Valve Regurgitation After Previous Correction of Complete Atrioventricular Septal Defect

Abstract: Patients with severe LAVVR post-ICR of CAVSD may undergo reoperation with acceptable postoperative mortality and morbidity; however, they are at an increased risk for developing postoperative LAVVR and subsequent reoperation.

Cited by 16 publications

References 20 publications

Repair of complete atrioventricular septal defect with tetralogy of Fallot

Repair of complete atrioventricular septal defect with tetralogy of Fallot

Surgical outcome of atrioventricular septal defect: A 10 years review

Left Atrioventricular Valve Regurgitation After Repair of Complete Atrioventricular Septal Defect

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