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Twenty-year experience with repair of complete atrioventricular septal defects. Ann Thorac Surg 1996 Aug;62(2):419-24

Date

08/01/1996

Pubmed ID

8694600

DOI

10.1016/0003-4975(96)00326-8

Scopus ID

2-s2.0-0030219735   83 Citations

Abstract

BACKGROUND: To determine factors predicting mortality and morbidity after repair of complete atrioventricular septal defect, we retrospectively analyzed preoperative, operative, and postrepair factors on the outcome of 115 consecutive complete atrioventricular septal defect repairs at The Children's Hospital of Wisconsin between January 1974 and December 1993.

METHODS: For the entire experience the operative mortality was 13.9% (16 patients). During the most recent era, January 1988 to December 1993, operative mortality was 3.6% (2 of 55 patients). This was significantly improved from the two previous eras, January 1974 to December 1980, 28% (7 of 25) and January 1981 to December 1987, 20% (7 of 35 patients) (p = 0.02). There were seven late deaths; 10-year actuarial survival, including operative mortality was 81%. Age at complete repair decreased; before 1982 all patients were more than 12 months of age, whereas after 1982 64% (56 of 88 patients) were 12 months of age or less.

RESULTS: Moderate or severe preoperative left atrioventricular valve regurgitation was not a risk factor for operative mortality. For operative survivors with moderate to severe preoperative left atrioventricular valve regurgitation (n = 17), late postoperative left atrioventricular valve regurgitation (follow-up data available on 15 patients) was significantly reduced (severe = 1, moderate = 5, mild = 9; p = 0.007).

CONCLUSIONS: Early mortality was predicted by the era of surgical repair. Conversion to routine repair during infancy was achieved with a simultaneous decrease in operative mortality. For patients with moderate to severe preoperative left atrioventricular valve regurgitation, significant improvement in the degree of left atrioventricular valve regurgitation can be expected without an increase in operative or late mortality or morbidity.

Author List

Tweddell JS, Litwin SB, Berger S, Friedberg DZ, Thomas JP, Frommelt PC, Frommelt MA, Pelech AN, Lewis DA, Fedderly RT, Mussatto KA, Kessel MW

Authors

Raymond T. Fedderly MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michele Ann Frommelt MD Professor in the Pediatrics department at Medical College of Wisconsin
Peter C. Frommelt MD Professor in the Pediatrics department at Medical College of Wisconsin
Kathleen Mussatto in the CTSI department at Medical College of Wisconsin - CTSI




MESH terms used to index this publication - Major topics in bold

Actuarial Analysis
Adolescent
Age Factors
Blood Pressure
Cause of Death
Child
Child, Preschool
Down Syndrome
Endocardial Cushion Defects
Follow-Up Studies
Forecasting
Heart Defects, Congenital
Humans
Infant
Mitral Valve Insufficiency
Pulmonary Artery
Respiration, Artificial
Retrospective Studies
Survival Rate
Treatment Outcome
Wisconsin
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc