Factors Associated with Moderate or Severe Left Atrioventricular Valve Regurgitation within 30 days of Repair of Incomplete Atrioventricular Septal Defect

Abstract

IntroductionLeft atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect.ObjectiveTo determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect.MethodsWe assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative left atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. The median age was 4.1 years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the time of preoperative evaluation, there were 23 cases with moderate or greater left atrioventricular valve regurgitation (45.1%). Abnormalities on the left atrioventricular valve were found in 17.6%; annuloplasty was performed in 21.6%.ResultsAt the time of postoperative evaluation, there were 12 cases with moderate or greater left atrioventricular valve regurgitation (23.5%). The variation between pre- and postoperative grades of left atrioventricular valve regurgitation of patients with atrioventricular valve malformation did not reach significance (P=0.26), unlike patients without such abnormalities (P=0.016). During univariate analysis, only absence of Down syndrome was statistically significant (P=0.02). However, after a multivariate analysis, none of the factors reached significance.ConclusionNone of the factors studied was determinant of a moderate or greater left atrioventricular valve regurgitation within the first 30 days of repair of incomplete atrioventricular septal defect in the sample. Patients without abnormalities on the left atrioventricular valve benefit more of the operation.

Efficacy of atrioventricular valve regurgitation in the first trimester for the diagnosis of atrioventricular septal defect

“…21 Kozak also found that preoperative echocardiography of 104 cases with AVSD showed 93% with mild or more severe common AVVR. 24,25 It was still lack of statistics of common AVVR in the first trimester, whereas our study found 91.89% cases with AVSD could show the common AVVR in the first trimester. Although 31 cases (31/37) were found abnormality with gray-scale four-chamber view, which was higher than 24 cases (24/37) with color Doppler four-chamber view, we did not utilize the gray-scale view to substitute color Doppler as the primary screening view.…”

“…Davey B reported that 81% fetuses in the second and third trimester with the AVSD showed common AVVR, and 96% showed the regurgitation in the neonatal period 21 . Kozak also found that preoperative echocardiography of 104 cases with AVSD showed 93% with mild or more severe common AVVR 24,25 . It was still lack of statistics of common AVVR in the first trimester, whereas our study found 91.89% cases with AVSD could show the common AVVR in the first trimester.…”