Abstract
Background
We describe the long-term results of partial atrioventricular septal defect (AVSD) repair in a single centre encompassing a 22-year period. Described are rates of survival, reoperation and complications.
Methods
We performed a retrospective review of 556 patients undergoing AVSD repair to identify the 51 patients who underwent partial AVSD repair in Our Lady’s Children’s Hospital, Crumlin, Ireland, between 1993 and 2015 with long-term follow-up where available.
Results
A total of 29 (56.8%) of patients were male and mean age at operation was 3.32 years. Mean weight was 13.2 kg. Trisomy 21 was present in 29 (56.8%). Five patients (9.6%) had undergone prior surgery. Mean cardiopulmonary bypass time was 89 ± 36 min and mean aortic cross-clamp time was 57 ± 28 min. One patient underwent partial AVSD repair and concomitant tracheal resection and extracorporeal membrane oxygenation decannulation. One patient was managed with suture atrial septal defect (ASD) closure, the remainder with patch repair of ASD and mitral cleft closure. The length of hospital stay was 9 ± 5 days. Median follow-up was 6.06 years (IQR, 1.65–10.2 years). There were no early mortalities. One patient died 1 year following surgery (1.9%). One patient required reoperation at an interval of 2 years for severe mitral regurgitation (1.9%).
Conclusions
Short- and long-term survival following partial AVSD repair in Ireland revealed excellent results compared with other published series. Reoperation incidence also compared excellently with other reports published in the literature.
Similar content being viewed by others
References
Calkoen EE, Hazekamp MG, Blom NA, Elders BB, Gittenberger-de Groot AC, Haak MC et al (2016) Atrioventricular septal defect: from embryonic development to long-term follow-up. Int J Cardiol 202:784–795
Jacobs JP, Burke RP, Quintessenza JA, Mavroudis C (2000) Congenital Heart Surgery Nomenclature and Database Project: atrioventricular canal defect. Ann Thorac Surg 69(4 Suppl):S36–S43
Bowman JL, Dearani JA, Burkhart HM, Goodloe AH, Phillips SD, Weaver AL, Eidem BW, Cetta F (2014) Should repair of partial atrioventricular septal defect be delayed until later in childhood? Am J Cardiol 114(3):463–467
Craig B (2006) Atrioventricular septal defect: from fetus to adult. Heart 92(12):1879–1885
Formigari R, Di Donato RM, Gargiulo G, Di Carlo D, Feltri C, Picchio FM et al (2004) Better surgical prognosis for patients with complete atrioventricular septal defect and Down’s syndrome. Ann Thorac Surg 78(2):666–672 discussion 72
Ni She R, Filan PM (2014) Trisomy 21—incidence and outcomes in the first year, in Ireland today. Ir Med J 107(8):248–249
Lillehei CW, Varco RL, Cohen M, Warden HE, Patton C, Moller JH (1986) The first open-heart repairs of ventricular septal defect, atrioventricular communis, and tetralogy of Fallot using extracorporeal circulation by cross-circulation: a 30-year follow-up. Ann Thorac Surg 41(1):4–21
Gott VL (2005) Lillehei, Lewis, and Wangensteen: the right mix for giant achievements in cardiac surgery. Ann Thorac Surg 79(6):S2210–S2213
Buratto E, McCrossan B, Galati JC, Bullock A, Kelly A, d’Udekem Y, Brizard CP, Konstantinov IE (2015) Repair of partial atrioventricular septal defect: a 37-year experience. Eur J Cardiothorac Surg 47(5):796–802
El-Najdawi EK, Driscoll DJ, Puga FJ, Dearani JA, Spotts BE, Mahoney DW et al (2000) Operation for partial atrioventricular septal defect: a forty-year review. J Thorac Cardiovasc Surg 119(5):880–889 discussion 9–90
Welke KF, Morris CD, King E, Komanapalli C, Reller MD, Ungerleider RM (2007) Population-based perspective of long-term outcomes after surgical repair of partial atrioventricular septal defect. Ann Thorac Surg 84(2):624–628 discussion 8–9
Kaza AK, Colan SD, Jaggers J, Lu M, Atz AM, Sleeper LA, McCrindle B, Lambert LM, Margossian R, Lacro RV, Richmond ME, Natarajan S, Minich LL, Pediatric Heart Network Investigators (2011) Surgical interventions for atrioventricular septal defect subtypes: the pediatric heart network experience. Ann Thorac Surg 92(4):1468–1475 discussion 75
Buckley JR, Graham EM, Gaies M, Alten JA, Cooper DS, Costello JM et al (2017) Clinical epidemiology and centre variation in chylothorax rates after cardiac surgery in children: a report from the Pediatric Cardiac Critical Care Consortium. Cardiol Young:1–8
Doell C, Bernet V, Molinari L, Beck I, Balmer C, Latal B (2011) Children with genetic disorders undergoing open-heart surgery: are they at increased risk for postoperative complications? Pediatr Crit Care Med 12(5):539–544
Domi T, Edgell DS, McCrindle BW, Williams WG, Chan AK, MacGregor DL et al (2008) Frequency, predictors, and neurologic outcomes of vaso-occlusive strokes associated with cardiac surgery in children. Pediatrics 122(6):1292–1298
Kelleher EM, Nolke L, McMahon CJ (2015) Successful slide tracheoplasty and partial atrioventricular septal defect repair following extracorporeal membrane oxygenation support. Cardiol Young 25(3):573–575
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval was sought and granted by the institutional ethics committee in Our Lady’s Children’s Hospital, Crumlin.
Conflict of interest
The authors declare that they have no conflicts of interest.
Rights and permissions
About this article
Cite this article
O’ Sullivan, K.E., Fleck, R., Vigano, G. et al. Long-term outcomes following partial atrioventricular septal defect (AVSD) repair in Ireland. Ir J Med Sci 188, 475–479 (2019). https://doi.org/10.1007/s11845-018-1855-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-018-1855-5