Edward Buratto1, Brian McCrossan2, John C Galati3, Andrew Bullock4, Andrew Kelly5, Yves d'Udekem6, Christian P Brizard6, Igor E Konstantinov6. 1. Cardiac Surgery Unit, The Royal Children's Hospital, Melbourne, Australia The University of Melbourne, Melbourne, Australia Murdoch Children's Research Institute, Melbourne, Australia igor.konstantinov@rch.org.au. 2. Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia. 3. Murdoch Children's Research Institute, Melbourne, Australia Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia. 4. Princess Margaret Hospital, Perth, Australia. 5. Women's and Children's Hospital, Adelaide, Australia. 6. Cardiac Surgery Unit, The Royal Children's Hospital, Melbourne, Australia The University of Melbourne, Melbourne, Australia Murdoch Children's Research Institute, Melbourne, Australia.
Abstract
OBJECTIVES: Partial atrioventricular septal defect (pAVSD) is routinely repaired with a low mortality. However, limited data are available on the long-term follow-up of these patients. The current study was designed to determine long-term survival and morbidity of a large cohort of patients operated on at a single institution. METHODS: From 1975 to 2012, 249 consecutive patients underwent pAVSD repair at the Royal Children's Hospital. The follow-up data were obtained from hospital records, correspondence with cardiologists and primary care physicians, patient surveys and the state death registry. RESULTS: The early mortality rate was 1.2% (3/249), while the long-term survival rate was 96% (95% CI: 93-98%) at 10 years and 94% (95% CI: 89-97%) at 30 years. Freedom from reoperation was 84% at 10 years and 75% at 30 years. The most common reoperations were left atrioventricular valve surgery (30/249, 12.1%), resection of left ventricular outflow tract obstruction (12/249, 4.8%) and closure of residual atrial septal defects (5/249, 2.0%). Implantation of a permanent pacemaker was required in 3.2% (8/249) of patients. Despite a substantial reoperation rate, only 43% of patients older than 18 years of age were seen by a cardiologist within the most recent 2 years of the study period, compared with 80% of those younger than 18 years (P < 0.001). CONCLUSIONS: Repair of pAVSD is performed with a low mortality and excellent long-term survival. However, a substantial reoperation rate warrants close follow-up into adulthood.
OBJECTIVES: Partial atrioventricular septal defect (pAVSD) is routinely repaired with a low mortality. However, limited data are available on the long-term follow-up of these patients. The current study was designed to determine long-term survival and morbidity of a large cohort of patients operated on at a single institution. METHODS: From 1975 to 2012, 249 consecutive patients underwent pAVSD repair at the Royal Children's Hospital. The follow-up data were obtained from hospital records, correspondence with cardiologists and primary care physicians, patient surveys and the state death registry. RESULTS: The early mortality rate was 1.2% (3/249), while the long-term survival rate was 96% (95% CI: 93-98%) at 10 years and 94% (95% CI: 89-97%) at 30 years. Freedom from reoperation was 84% at 10 years and 75% at 30 years. The most common reoperations were left atrioventricular valve surgery (30/249, 12.1%), resection of left ventricular outflow tract obstruction (12/249, 4.8%) and closure of residual atrial septal defects (5/249, 2.0%). Implantation of a permanent pacemaker was required in 3.2% (8/249) of patients. Despite a substantial reoperation rate, only 43% of patients older than 18 years of age were seen by a cardiologist within the most recent 2 years of the study period, compared with 80% of those younger than 18 years (P < 0.001). CONCLUSIONS: Repair of pAVSD is performed with a low mortality and excellent long-term survival. However, a substantial reoperation rate warrants close follow-up into adulthood.
Authors: Logan G Spector; Jeremiah S Menk; Jessica H Knight; Courtney McCracken; Amanda S Thomas; Jeffrey M Vinocur; Matthew E Oster; James D St Louis; James H Moller; Lazaros Kochilas Journal: J Am Coll Cardiol Date: 2018-05-29 Impact factor: 24.094
Authors: Yaroslav Ivanov; Edward Buratto; Phillip Naimo; Adrienne Lui; Thomas Hu; Yves d'Udekem; Christian P Brizard; Igor E Konstantinov Journal: Interact Cardiovasc Thorac Surg Date: 2022-03-31