Repair of complete atrioventricular septal defect between 2 and 3.5 kilograms: Defining the limits of safe repair.
J Thorac Cardiovasc Surg
; 164(4): 1167-1175, 2022 10.
Article
em En
| MEDLINE
| ID: mdl-35341580
ABSTRACT
OBJECTIVES:
Repair of complete atrioventricular septal defect (cAVSD) is routinely performed at around 3 months of age with good results. However, some patients require earlier surgery due to heart failure or failure to thrive. It is uncertain whether cAVSD repair performed on patients ≤3.5 kg leads to increased mortality and reoperation on the left atrioventricular valve.METHODS:
All patients who underwent cAVSD repair from 1990 to 2019 at a single institution were included in the study. Data were obtained from retrospective review of medical records and correspondence with cardiologists.RESULTS:
Of 456 patients, 12.9% (59/456) weighed ≤3.5 kg at time of repair. This group was younger (P < .01) and had greater rates of heart failure (P < .01) and failure to thrive (P = .02). There was no significant difference in early mortality between the 2 groups (1.7% [1/59] vs 3.0% [12/397], P = 1.0). Survival at 20 years was 83.8% in those ≤3.5 kg, compared with 90.4% in those >3.5 kg, with no significant difference between the 2 groups (P = .68). Freedom from left atrioventricular valve reoperation at 20 years was 73.6% in those ≤3.5 kg, compared with 74.5% in those >3.5 kg, with no significant difference between the 2 groups (P = .45).CONCLUSIONS:
Repair of cAVSD in children ≤3.5 kg appears to be safe, with similar overall survival and freedom from reoperation compared with those >3.5 kg. These findings add further support to an approach of early complete repair in children with severe heart failure or failure to thrive.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Cardíaca
/
Defeitos dos Septos Cardíacos
/
Doenças das Valvas Cardíacas
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Child
/
Humans
/
Infant
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Austrália