Abstract
IntroductionLeft atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect.ObjectiveTo determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect.MethodsWe assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative left atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. The median age was 4.1 years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the time of preoperative evaluation, there were 23 cases with moderate or greater left atrioventricular valve regurgitation (45.1%). Abnormalities on the left atrioventricular valve were found in 17.6%; annuloplasty was performed in 21.6%.ResultsAt the time of postoperative evaluation, there were 12 cases with moderate or greater left atrioventricular valve regurgitation (23.5%). The variation between pre- and postoperative grades of left atrioventricular valve regurgitation of patients with atrioventricular valve malformation did not reach significance (P=0.26), unlike patients without such abnormalities (P=0.016). During univariate analysis, only absence of Down syndrome was statistically significant (P=0.02). However, after a multivariate analysis, none of the factors reached significance.ConclusionNone of the factors studied was determinant of a moderate or greater left atrioventricular valve regurgitation within the first 30 days of repair of incomplete atrioventricular septal defect in the sample. Patients without abnormalities on the left atrioventricular valve benefit more of the operation.
Highlights
Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect
Many factors associated to reoperation have been proposed[1,2,4,6], but there is a lack of data reporting factors associated with immediate postoperative left atrioventricular valve regurgitation (LAVVR), the reports of valve replacement and of in-hospital deaths due to significant residual LAVVR within 30 days of operation[1,5,7]
The goal of this study was to assess whether some of the previous risk factors published in the literature would be associated to an at least moderate LAVVR within 30 days of surgical repair at our practice, in Brazil
Summary
Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect. Objective: To determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect. Many factors associated to reoperation have been proposed[1,2,4,6], but there is a lack of data reporting factors associated with immediate postoperative LAVVR, the reports of valve replacement and of in-hospital deaths due to significant residual LAVVR within 30 days of operation[1,5,7] To improve these statistics, a clear outline of the predisposing factors leading to a worse immediate surgical outcome is essential. The goal of this study was to assess whether some of the previous risk factors published in the literature would be associated to an at least moderate LAVVR within 30 days of surgical repair at our practice, in Brazil
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