Mortality and reoperation outcomes after repair of complete atrioventricular septal defect with a modified single-patch technique: a single-center experience
10.3760/cma.j.cn112434-20230815-00033
- VernacularTitle:改良单片法治疗完全性房室间隔缺损术后死亡与再手术结果：单中心经验
- Author:
Ming FAN
1
;
Xuming MO
;
Di YU
;
Jirong QI
;
Jian SUN
;
Wei PENG
;
Kaihong WU
Author Information
1. 江南大学附属儿童医院（无锡市儿童医院）心胸外科，无锡 214000
- Keywords:
Complete atrioventricular septal defect;
Children;
Reoperation;
Risk factors
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(8):451-458
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the risk factors of reoperation and mortality after complete atrioventricular septal defect repair, and to evaluate the medium and long-term prognosis.Methods:From March 2008 to March 2022, a total of 266 children were selected from the Department of Thoracic and Cardiovascular Surgery, Nanjing Children's Hospital, who underwent the complete atrioventricular septal defect repair. Exclusion of children with conotrucal anomaly such as tetralogy of Fallot, transposition of the great arteries, and right ventricular double outlet. Demographic characteristics, surgical data, postoperative follow-up and associated risk factors were analyzed.Results:All the children were repaired with modified single-piece method for the first time, and 26 children were reoperated because of severe left atrioventricular valve regurgitation, left ventricular outflow tract obstruction and atrioventricular block. The 1-year, 3-year and 5-year overall survival rate and freedom from reoperation rate of all children were (98.1±0.8)%, (97.3±1.0)%, (96.2±1.2)%, (96.6±1.1)%, (93.9±1.5)% and (92.2±1.7)%, respectively. A total of 11 (42.3%) early reoperations and 15 (57.7%) late reoperations were performed, of which 1-year, 3-year and 5-year survival rates were (92.3±5.2)%, (82.1±8.3)% and (76.6±9.4)% respectively. Multifactorial analysis showed that age <3 months and left atrioventricular regurgitation >grade 2 at 24 hours postoperatively were independent risk factors for reoperation, whereas age <3 months and experience of reoperation were independent risk factors for death of children.Conclusion:Complete atrial septal defects have excellent surgical outcomes, but some children still require reoperation, and age <3 months and postoperative left atrioventricular valve regurgitation(LAVVR)>2 grades remain important predictors of their surgical prognosis.
