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Partial and transitional atrioventricular septal defect outcomes.

Publication ,  Journal Article
Minich, LL; Atz, AM; Colan, SD; Sleeper, LA; Mital, S; Jaggers, J; Margossian, R; Prakash, A; Li, JS; Cohen, MS; Lacro, RV; Klein, GL ...
Published in: Ann Thorac Surg
February 2010

BACKGROUND: Surgical and perioperative improvements permit earlier repair of partial and transitional atrioventricular septal defects (AVSD). We sought to describe contemporary outcomes in a multicenter cohort. METHODS: We studied 87 patients undergoing primary biventricular repair of partial or transitional AVSD between June 2004 and February 2006 across seven North American centers. One-month and 6-month postoperative data included weight-for-age z-scores, left atrioventricular valve regurgitation (LAVVR) grade, residual shunts, and left ventricular ejection fraction. Paired methods were used to assess 6-month change. RESULTS: Median age at surgery was 1.8 years; median weight z-score was -0.88. Median days for ventilation were 1, intensive care 2, and hospitalization 5, all independent of age, with 1 in-hospital death. At 1 month, 27% (16 of 73) had ejection fraction less than 55%; 20% (17 of 87) had significant LAVVR; 2 had residual shunts; 1 each had subaortic stenosis and LAVV stenosis. At 6 months (n = 60), there were no interim deaths, reinterventions, or new development of subaortic or LAVV stenosis. Weight z-score improved by a median 0.4 units (p < 0.001), especially for underweight children less than 18 months old. Left atrioventricular valve regurgitation occurred in 31% (change from baseline, p = 0.13), occurring more frequently in patients repaired at 4 to 7 years (p = 0.01). Three patients had ejection fraction less than 55%, and 1 had a residual atrial shunt. CONCLUSIONS: Surgical repair for partial/transitional AVSD is associated with low morbidity and mortality, short hospital stays, and catch-up growth, particularly in underweight children repaired between 3 and 18 months of age. Left atrioventricular valve regurgitation remains the most common residual defect, occurring more frequently in children repaired after 4 years of age.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

February 2010

Volume

89

Issue

2

Start / End Page

530 / 536

Location

Netherlands

Related Subject Headings

  • Tricuspid Valve Insufficiency
  • Treatment Outcome
  • Respiratory System
  • Reoperation
  • Prospective Studies
  • Prognosis
  • Postoperative Complications
  • Mitral Valve Insufficiency
  • Male
  • Length of Stay
 

Citation

APA
Chicago
ICMJE
MLA
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Minich, L. L., Atz, A. M., Colan, S. D., Sleeper, L. A., Mital, S., Jaggers, J., … Pediatric Heart Network Investigators, . (2010). Partial and transitional atrioventricular septal defect outcomes. Ann Thorac Surg, 89(2), 530–536. https://doi.org/10.1016/j.athoracsur.2009.10.047
Minich, L LuAnn, Andrew M. Atz, Steven D. Colan, Lynn A. Sleeper, Seema Mital, James Jaggers, Renee Margossian, et al. “Partial and transitional atrioventricular septal defect outcomes.Ann Thorac Surg 89, no. 2 (February 2010): 530–36. https://doi.org/10.1016/j.athoracsur.2009.10.047.
Minich LL, Atz AM, Colan SD, Sleeper LA, Mital S, Jaggers J, et al. Partial and transitional atrioventricular septal defect outcomes. Ann Thorac Surg. 2010 Feb;89(2):530–6.
Minich, L. LuAnn, et al. “Partial and transitional atrioventricular septal defect outcomes.Ann Thorac Surg, vol. 89, no. 2, Feb. 2010, pp. 530–36. Pubmed, doi:10.1016/j.athoracsur.2009.10.047.
Minich LL, Atz AM, Colan SD, Sleeper LA, Mital S, Jaggers J, Margossian R, Prakash A, Li JS, Cohen MS, Lacro RV, Klein GL, Hawkins JA, Pediatric Heart Network Investigators. Partial and transitional atrioventricular septal defect outcomes. Ann Thorac Surg. 2010 Feb;89(2):530–536.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

February 2010

Volume

89

Issue

2

Start / End Page

530 / 536

Location

Netherlands

Related Subject Headings

  • Tricuspid Valve Insufficiency
  • Treatment Outcome
  • Respiratory System
  • Reoperation
  • Prospective Studies
  • Prognosis
  • Postoperative Complications
  • Mitral Valve Insufficiency
  • Male
  • Length of Stay