Cirugía de reparación valvular mitral en el canal auriculoventricular completo

Abstract

Introduction and objectivesComplete atrio-ventricular septal defect accounts for 3% of congenital heart disease. Its prognosis depends on the status of the left atrio-ventricular valve after repair. We will analyse our results in terms of morbidity and mortality, and need for reoperation. MethodsRetrospective observational study, including patients who underwent a complete surgical correction of atrio-ventricular septal defect in our centre between January 2008 and July 2021. Results57 patients were treated. Median age and weight were 6 months and 5.8kg respectively (interquartile range 4-7 months and 4.8-6.7kg). Inhospital mortality was 3 patients (5.3%). Of the patients, 7.2% required early reoperation to the left atrio-ventricular valve. Overall survival was 88.6% (median follow-up of 4.7 years; interquartile range: 1.5-10.9; complete follow-up in 93% of patients). Freedom from reoperation to the left atrioventricular valve was 83.7%. The left atrioventricular valve showed regurgitation lower than III / IV in 90.2% of the patients at the end of follow-up. Surgery before 3 months (p=.001), preoperative pulmonary hypertension (p=.007), and postoperative left atrio-ventricular valve stenosis (p=.001) were risk factors for mortality. Weight less than 4kg (p<.0001), age less than 3 months (p<.0001), no closure of the cleft (p=.033), and postoperative valve stenosis (p<.0001) were risk factors for valve reoperation. ConclusionsSurgical correction of atrioventricular septal defect between 3 and 6 months shows good morbidity and mortality results.Closure of the cleft prevents the need for reoperation to the left atrioventricular valve.