Early and mid-term results of surgical treatment of atrioventricular septal defect; analysis of risk factors for adverse outcomes: left atrioventricular valve regurgitation

Abstract

Background Advances in the perioperative management and optimization of the timing of primary repair have gradually improved the early clinical outcome of surgical correction of atrioventricular septal defects (AVSDs). However, the late outcome still remains compromised by the substantial risk of reoperation, of which mainly the development of left ventricular outflow tract obstruction (LVOTO) and left atrioventricular valve (LAVV) dysfunction challenge the long-term survival and morbidity of these children. In particular, LAVV regurgitation (LAVVR) is responsible for a reoperation rate between 5 and 19%, both for complete AVSD (cAVSD) and partial AVSD (PAVSD) children. Results of surgical correction of AVSDs) have improved over the last decades; however, the need for reoperation after primary AVSD repair remains a major concern. We conducted this study to analyze risk factors leading to LAVVR in the early and mid-term follow-up postsurgical repair of AVSD. Patients and methods All patients who underwent biventricular repair for AVSD at our institute, in the time between Jan 2015 and Jan 2021, meeting the inclusion criteria and none of the exclusion criteria were enrolled in the study. Preoperative, operative and postoperative data were collected from the patients’ medical file. Last follow-up Echoes were reviewed. Results Patients who had preoperative and early postoperative more than moderate LAVVR are more likely to develop LAVVR in the late follow-up and also have a more risk to need a reoperation in their midterm follow-up. Conclusions Patients who had preoperative and early postoperative more than mod LAVVR are more likely to develop LAVVR in the late follow-up and also more likely to need reoperation.