Key result
CAVSD repair after August 2006 linked to lower overall mortality versus earlier surgical eras.
Why the study?
Do surgical era, technique, and patient age impact mortality and morbidity in patients undergoing complete atrioventricular septal defect repair?
Cohort (n=147)
Do surgical era, technique, and patient age impact mortality and morbidity in patients undergoing complete atrioventricular septal defect repair?
p-value: p=< 0.01
Younger patient age at surgery and better preoperative atrioventricular valve function, rather than the specific surgical technique used, are the primary factors associated with favorable outcomes in complete atrioventricular septal defect repair.
Improved survival after 2006 in complete AVSD repair may guide expectations; leaves open causal factors and prospective validation.
BACKGROUND: This study was conducted to evaluate the outcomes of patients undergoing complete atrioventricular septal defect (CAVSD) repair with particular attention to age at surgery, surgical era, and technique. METHODS: One hundred and forty-seven patients undergoing CAVSD repair between November 2002 and February 2012 were grouped according to surgical era and technique. Group I (age: 9.4 ± 5.0 months; weight: 6.8 ± 1.7 kg) consisted of 45 patients, operated before August 2006, and was divided into subgroup Ia (31 patients; two-patch repair) and subgroup Ib (14 patients; modified single-patch repair). One hundred and two patients operated after August 2006 were included in Group II (age: 5.2 ± 3.1 months; weight: 4.9 ± 2.6 kg), and was divided into subgroup IIa (59 patients; two-patch repair) and subgroup IIb (43 patients; modified single-patch repair). Groups were compared with regard to perioperative variables and postoperative data. RESULTS: There were 19 early and five late deaths. Overall mortality was significantly higher in Group I, compared to Group II (p < 0.01). Comparison of Groups Ia to Ib and IIa to IIb revealed no statistically significant difference in mortality or morbidity. Age >8 months and preoperative common atrioventricular valve (CAVV) regurgitation ≥ moderate were significant risk factors for mortality and morbidity. After 40.8 ± 24.4 months, 99 (80.4%) of 123 (83.7%) survivors were asymptomatic without any medication, and 24 (19.5%) have mild symptoms. CONCLUSION: Our current results indicate that younger patient age and better preoperative CAVV functions were the main factors for a favorable outcome after surgical correction of CAVSD; and outcomes did not differ by the surgical technique.
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Harmandar et al. (2012) conducted a cohort in Complete atrioventricular septal defect (CAVSD) (n=147). Surgical correction of CAVSD after August 2006 vs. Surgical correction before August 2006 was evaluated on Overall mortality (p=< 0.01). Surgical correction of complete atrioventricular septal defect after August 2006 was associated with significantly lower overall mortality compared to earlier surgical eras (p < 0.01).
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