Outcomes of Atrioventricular Septal Defects Surgery in Senegal

Introduction: The incidence of atrioventricular septal defect (AVSD) varies between 0.24 to 0.31 per 1000 births and represents 4% of congenital heart disease. AVSD surgery has known a fast evolution with better results due to a better perioperative management of these patients and an earlier complete cure in the first 3 to 6 months. In Senegal, AVSD surgery represents a real challenge because a diagnosis is most often late. These patients are operated on at a later age. It is in this context that this work was carried out to see the results of the surgery of these patients and compared them with those of the literature. The aims of this work were to study the epidemiological profile as well as the clinical specificities of AVSD; to evaluate the results of surgery in terms of morbidity and mortality. Materials and Methods: This is a retrospective, descriptive and analytical study carried out from the chart of patients followed at the CUOMO cardio-pediatric center in Dakar over a period from January 2017 to May 2021. Results: The average age of patients is 77 months. The average duration of cardiopulmonary bypass (CPB) was 151 ± 78 min (62–375min), the average duration of aortic cross clamping was 113 ± 63.8 min (41-271min). Morbidity was dominated by heart rhythm disorders (13%) and hemodynamic instability (13%). The early mortality rate was 13% (3 patients), late mortality was nil. The mortality risk factors that were found in our study are patients with a diagnosis of complete AVSD, a CPB duration greater than 150 min, an intubation duration greater than 45 hours and an inotropic support duration greater than 136 hours. Conclusion: Our long-term results are satisfactory and encouraging in terms of survival and quality of life. Even though they were operated late most often beyond the indicated period, we have had good results in the follow-up of these patients after surgery. The recommendations go to the earlier management of these patients in our countries with an awareness in early diagnosis and more appropriate care to further reduce morbidity and mortality.