Early Repair of Complete Atrioventricular Septal Defect is Safe and Effective

R. Ramesh Singh, Patrick S. Warren, T. Brett Reece, Peter Ellman, Benjamin B. Peeler, Irving L. Kron

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Surgical repair of complete atrioventricular septal defect (CAVSD) is a well-established procedure performed on young children. Our hypothesis is that with modern techniques, the current risks of CAVSD repair in children aged younger than 3 months and in children older than 3 months are equal. Methods: This was a retrospective review of 65 infants and children with a mean age of 10.9 months (range, 1 month to 15.5 years) who underwent CAVSD repair from 1990 to 2004. Twenty-six repairs (40%) were done on or before 3 months of age (group A) and 39 repairs (60%) were done after 3 months of age (group B). In all patients, the ventricular septal defect was repaired with an individualized approach according to each patient's specific anatomy: direct suturing without a patch, interposition of a small pericardial patch with a running suture, or both. The atrioventricular commissure was closed with interrupted sutures, and all atrial defects were closed with a pericardial patch. Data were analyzed using the χ2 analysis and the Fisher exact test. Results: Three hospital deaths occurred (<30 days), 2 in group A and 1 in group B (7.7% vs 2.6%, respectively, p = 0.33). One death in group A occurred during another noncardiac surgery. Early reoperation (<1 year of initial surgery) for residual ventricular septal defect or significant mitral regurgitation, or both, occurred in 3 group A patients and in 4 group B patients (11.5% versus 10.3% respectively, p = 0.68). Conclusions: These results suggest that repair of CAVSD defects in children 3 months of age or younger had similar outcomes compared with those who underwent surgical repair after 3 months of age.

Original languageEnglish (US)
Pages (from-to)1598-1602
Number of pages5
JournalAnnals of Thoracic Surgery
Volume82
Issue number5
DOIs
StatePublished - Nov 1 2006
Externally publishedYes

Fingerprint

Ventricular Heart Septal Defects
Sutures
Age Groups
Mitral Valve Insufficiency
Reoperation
Anatomy
Complete atrioventricular septal defect

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Early Repair of Complete Atrioventricular Septal Defect is Safe and Effective. / Singh, R. Ramesh; Warren, Patrick S.; Reece, T. Brett; Ellman, Peter; Peeler, Benjamin B.; Kron, Irving L.

In: Annals of Thoracic Surgery, Vol. 82, No. 5, 01.11.2006, p. 1598-1602.

Research output: Contribution to journalArticle

Singh, R. Ramesh ; Warren, Patrick S. ; Reece, T. Brett ; Ellman, Peter ; Peeler, Benjamin B. ; Kron, Irving L. / Early Repair of Complete Atrioventricular Septal Defect is Safe and Effective. In: Annals of Thoracic Surgery. 2006 ; Vol. 82, No. 5. pp. 1598-1602.
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abstract = "Background: Surgical repair of complete atrioventricular septal defect (CAVSD) is a well-established procedure performed on young children. Our hypothesis is that with modern techniques, the current risks of CAVSD repair in children aged younger than 3 months and in children older than 3 months are equal. Methods: This was a retrospective review of 65 infants and children with a mean age of 10.9 months (range, 1 month to 15.5 years) who underwent CAVSD repair from 1990 to 2004. Twenty-six repairs (40{\%}) were done on or before 3 months of age (group A) and 39 repairs (60{\%}) were done after 3 months of age (group B). In all patients, the ventricular septal defect was repaired with an individualized approach according to each patient's specific anatomy: direct suturing without a patch, interposition of a small pericardial patch with a running suture, or both. The atrioventricular commissure was closed with interrupted sutures, and all atrial defects were closed with a pericardial patch. Data were analyzed using the χ2 analysis and the Fisher exact test. Results: Three hospital deaths occurred (<30 days), 2 in group A and 1 in group B (7.7{\%} vs 2.6{\%}, respectively, p = 0.33). One death in group A occurred during another noncardiac surgery. Early reoperation (<1 year of initial surgery) for residual ventricular septal defect or significant mitral regurgitation, or both, occurred in 3 group A patients and in 4 group B patients (11.5{\%} versus 10.3{\%} respectively, p = 0.68). Conclusions: These results suggest that repair of CAVSD defects in children 3 months of age or younger had similar outcomes compared with those who underwent surgical repair after 3 months of age.",
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