Key result
Reoperation for severe left atrioventricular valve regurgitation after initial CAVSD repair resulted in 4.5% hospital mortality and 5-year overall and free-reoperation survival of 92.8% and 72%.
Why the study?
What are the early and late outcomes of reoperation for severe LAVVR after initial complete repair of CAVSD?
Cohort (n=45)
What are the early and late outcomes of reoperation for severe LAVVR after initial complete repair of CAVSD?
Reoperation for severe LAVVR after initial repair of CAVSD has acceptable mortality but carries a significant risk of subsequent reoperation.
Acceptable mortality after LAVVR reoperation in repaired CAVSD; extends observational survival data but leaves optimal strategies open for prospective study.
OBJECTIVES: The aims of this study were to evaluate the early and late outcomes in patients undergoing reoperation due to left atrioventricular valve regurgitation (LAVVR) after initial complete repair (ICR) of complete atrioventricular septal defect (CAVSD). MATERIALS AND METHOD: Between January 1990 and April 2013, 45 consecutive patients underwent reoperation due to severe LAVVR. The mean age was 7.5 ± 6.2 years. Associated LAVV malformations were found in 22 (49%) patients and associated cardiac malformations in 18 (40%). The mean follow-up was 6.8 ± 2.6 years. RESULTS: LAVV repair was possible in all patients. There were two hospital deaths (4.5%). Ten patients (22%) required a second reoperation due to severe LAVVR at mean 7.5 ± 8.4 months after the first reoperation. The actuarial overall survival and free-reoperation survival rates at one, three, and five years were 95.4%, 92.8%, and 92.8% and 89%, 80.5%, and 72%, respectively. Multivariate analysis revealed that the associated cardiac malformations, LAVV leaflet prolapse or detachment from the septal patch, associated LAVV malformations, and post-first correction LAVVR grade ≥ 2 were strong predictors for poor overall free-reoperation survival in patients undergoing reoperation due to LAVVR after ICR of various forms of ACVSD. CONCLUSIONS: Patients with severe LAVVR post-ICR of CAVSD may undergo reoperation with acceptable postoperative mortality and morbidity; however, they are at an increased risk for developing postoperative LAVVR and subsequent reoperation.
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Prifti et al. (2013) conducted a cohort in Left atrioventricular valve regurgitation after initial complete repair of complete atrioventricular septal defect (n=45). Reoperation for severe left atrioventricular valve regurgitation was evaluated on Early and late outcomes (hospital death, second reoperation, overall survival, free-reoperation survival). Reoperation for severe left atrioventricular valve regurgitation after initial CAVSD repair resulted in 4.5% hospital mortality and 5-year overall and free-reoperation survival of 92.8% and 72%.
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