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August 26, 2026European Journal of Cardio-Thoracic SurgeryOpen Access

Predictors of reoperation and mortality after complete atrioventricular septal defect repair

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Why the study?

Previous studies of risk factors for reoperation or mortality after complete atrioventricular septal defect repair often lacked sizeable cohorts undergoing modified single-patch repair.

What are the risk factors associated with reoperation or mortality following complete atrioventricular septal defect repair?

Population

829 patients undergoing biventricular surgical repair of CAVSD at 4 centres in Australia

Design

Multi-institutional cohort study

Follow-up

Up to 20 years

Key result

Following biventricular surgical repair of complete atrioventricular septal defect, early reoperation occurred in 6.8% of patients and operative mortality was 3.3%.

Authors

LFLaura S. FongKBKim BettsJAJulian Ayer

Discussion

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Overview

Informs postoperative risk stratification for complete atrioventricular septal defect repair; leaves open.

Key Points

  • To determine the risk factors associated with reoperation and long-term mortality following biventricular surgical repair of complete atrioventricular septal defect.
  • Multi-institutional cohort study of 829 patients undergoing biventricular CAVSD repair across 4 centres in Australia between January 1990 and December 2015.
  • Excluded patients with associated tetralogy of Fallot and other conotruncal abnormalities; tracked postoperative outcomes, echocardiograms, reoperations, and overall survival.
  • Early reoperation occurred in 6.8% (n=56), with freedom from reoperation rates of 82.7% at 10 years, 81.1% at 15 years, and 77.0% at 20 years; absence of Down syndrome and postoperative moderate left atrioventricular valve regurgitation were independent risk factors.
  • Operative mortality was 3.3%, with 10-, 15-, and 20-year overall survival rates of 91.7%, 90.7%, and 88.7%, respectively.
  • Prior pulmonary artery banding independently predicted mortality, whereas surgery in the contemporary era (2010–2015) was associated with significantly improved survival.

Study Design

Type

Cohort (n=829)

Multicenter

Yes

Structured PICO

What are the risk factors associated with reoperation or mortality following complete atrioventricular septal defect repair?

P
Population
829 patients who underwent biventricular surgical repair of complete atrioventricular septal defect in Australia between 1990 and 2015, followed for up to 20 years.
E
Exposure
Biventricular surgical repair of complete atrioventricular septal defect (CAVSD)
O
Outcome
Reoperation or mortalityhard clinical

Primary CAVSD repair should be preferred over palliation with pulmonary artery banding due to the latter's association with long-term mortality.

Coverage & sources

Journal, society, and media accounts. Useful signal, not independent expert judgment.

Cite This Study

Fong et al. (2021) conducted a cohort in Complete atrioventricular septal defect (n=829). Biventricular surgical repair of complete atrioventricular septal defect was evaluated on Reoperation and mortality. Following biventricular surgical repair of complete atrioventricular septal defect, early reoperation occurred in 6.8% of patients and operative mortality was 3.3%.

synapsesocial.com/papers/6a8f58456911f20f604da040https://doi.org/10.1093/ejcts/ezab221
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