Atrioventricular discordance: Results of repair in 127 patients

Abstract

Analysis of conventional management of atrioventricular discordance revealed cumulative increases in mortality, systemic atrioventricular valve (tricuspid) replacement, complete atrioventricular block, and incidence of reoperation. Alternative management should be examined.

Midterm evaluation of echocardiographic examination, cardiac catheterization findings and surgical results of patients with congenitally corrected transposition of great arteries: A single center experience

“…As in our patient group, it is implemented to treat conduit stenosis by percutaneous intervention in patients underwent surgery or for device occlusion of Fontan fenestration. In these patients, before cardiac catheterization equipment should be ready for temporary or permanent pacemaker implantation because of anteriorly located AV node and fragile conduction system (20) . Presence of clinically important accompanying abnormalities such as ventricular septal defect (VSD), pulmonary stenosis (PS)/atresia can necessitate surgical intervention.…”

“…The persistence of the morphologic right ventricle as systemic ventricle had resulted in progressive tricuspid regurgitation and ended up with systemic ventricular dysfunction. In terms of long-term results, it was disappointing (1,6,20) . Lundstom et al reported premature deaths in 11 out of 51 cases.…”

“…Lundstom et al reported premature deaths in 11 out of 51 cases. In addition, Hraska et al reported 10 year-survival rate as 70%, whereas Yeh et al reported 20 year survival rate as 48% and in 56% of the cases the need for reoperation arised (19,20) . Ebstein's malformation of the tricuspid valve and systemic ventricular dysfunction are the most important risk factors in these patients, so implementation of surgical approaches alternative to the conventional repair is important for the long-term prognosis of these patients.…”

Congenitally corrected transposition of the great arteries: Current treatment options

“…All of these patients had normal left ventricular function with good hemodynamic parameters and all remained asymptomatic at a mean follow-up of 7.6 years (range of 0.5 to 10 years). • The longest surgical follow-up series in CCTGAs was reported by Yeh et al [25], who described the outcome of 127 patients over a 40-year time period • Most recently, Friesen et al [27] reported 7% early mortality among 28 patients with CCTGAs who underwent anatomic repair at Boston Children's Hospital from 1992 to 2002. Of these patients, the DS/AS was performed in 11 patients and DS/R in 17.…”

“…In contrast to most other studies, early follow-up in this study demonstrated equivalent operative mortality for the DS and conventional surgery was associated with a high PM requirement (35% in all patients) for AV block, but long-term follow-up for the DS patients was insufficient to conclude superiority of either approach. Differences in survival may not be evident until a 10-year follow-up has elapsed[25].• Tricuspid valve function was assessed by transthoracic echocardiography performed in 97 patients with AV discordance after palliative procedures, including PA band and Blalock-Taussig shunt, and corrective procedures, including anatomic and physiologic repair. TR increased significantly following Blalock-Taussig shunt, presumably due to volume loading of the systemic RV; TR was significantly reduced following PA banding and anatomic repair, due to reduction of the systemic RV volume.…”