RF69 REOPERATION AFTER ATRIO-VENTRICULAR SEPTAL DEFECTS CORRECTION

Abstract

Background and aim: Atrio-Ventricular Septal Defect (AVSD) encompasses a wide range of anatomical alternatives that make surgery and results very variable. We retrospectively reviewed our surgical experience with these patients, searching for outcome predictors. Methods: We investigated 202 patients, operated for AVSD Correction at our Institution since 1996. Complete and Partial AVSD were analyzed separately (Groups A and B respectively). Age, Down Syndrome, Left Superior Vena Cava, previous Pulmonary Banding and surgical technique were assessed to evaluate whether they could impact on results, survival and reoperation. Results: Complete AVSD was diagnosed in 113 patients (Group A) and partial in 89 (Group B). Total mortality was 4.5% (Group A 7%, Group B 1%). Increased risk was associated with previous Pulmonary Banding in Group A (p < 0.001) and Cleft left open at surgery in Group B (p < 0.05). Twenty-Three patients (11%) underwent reoperation (Group A 12%, Group B 10%) at a mean interval of 43 ± 49 months. All patients underwent mitral repair. Predictors of reoperation were presence of a left Superior Vena Cava in Group B (p < 0.01) and Cleft left open at surgery in both Groups (p < 0.05). Conclusions: Surgical results of AVSD repair are excellent, with low mortality and reoperation rate, without significant differences between Groups. A Cleft left open at surgery represents a strong predictor for reoperation.