Early repair of complete atrioventricular septal defect has better survival than staged repair after pulmonary artery banding: A propensity score–matched study

Buratto, Edward; Hu, Thomas; Lui, Adrienne; Wu, Damien M.; d’Udekem, Yves; Konstantinov, Igor E.

doi:10.1016/j.jtcvs.2020.07.106

Cited by 21 publications

(21 citation statements)

References 20 publications

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“…There was a downward trend in early mortality over time: early mortality was 4.2% (8 of 192) mortality in the range of 1%-2% in the modern era. [1][2][3][4]8,9 It is clear that repair of cAVSD can be carried out routinely in patients of 3-6 months of age with a very low mortality. Furthermore, long-term survival is also excellent, with 90% of patients alive at 20 years of follow-up.…”

Section: Results Baseline Characteristicsmentioning

confidence: 99%

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Propensity Score Matched Analysis of Cleft Closure in Complete Atrioventricular Septal Defect Repair

Buratto

Lui

et al. 2022

The Annals of Thoracic Surgery

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Section: Results Baseline Characteristicsmentioning

confidence: 99%

“…1 That was certainly our experience in Chicago when we were using the two-patch technique. 2 In this issue of The Annals of Thoracic Surgery, this surgical dogma has been called into question by Buratto…”

Section: Results Baseline Characteristicsmentioning

confidence: 99%

Propensity Score Matched Analysis of Cleft Closure in Complete Atrioventricular Septal Defect Repair

Buratto

Lui

et al. 2022

The Annals of Thoracic Surgery

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“…CPB temperature was controlled at an average of 32.44±1.92 ℃. After surgery, the median mechanical ventilation time was 27.5 (61.63) hours and the median of LOS in the intensive care unit (ICU) was 3.5 [2][3][4][5][6][7] [19-47.25] and 11.0 [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] hours; P<0.001}, and postoperative LOS in the ICU {6 [5][6][7][8][9][10][11] vs. 3 [2][3][4] and 2 [1-3] days; P<0.001} were significantly longer in the C-group compared to both the T-group and P-group. Furthermore, the incidence of complications was 28.4% (19/67) in the C-group, which was significantly higher than 7.7% (2/26) in the T-group and 8.8% (5/57) in the P-group (P=0.005).…”

Section: Peri-operative Datamentioning

confidence: 99%

Middle to long-term outcomes of surgical repair for atrioventricular septal defect: a single-center study

Cai¹,

Chen²,

Chen³

et al. 2022

J Thorac Dis

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Background: The exact incidence and predictors of mortality and left atrioventricular valve (LAVV) reoperation in congenital atrioventricular septal defect (AVSD) repair are still unclear. This study analyzed the middle to long-term outcomes of surgical repair for AVSD.Methods: A total of 150 patients (69 males and 81 females) who underwent AVSD repair at Children's Hospital of Fudan University from January 2013 to December 2021 were divided into complete defect group (C-group, 67 cases), transitional defect group (T-group, 26 cases), and partial defect group (P-group, 57 cases). Outcomes during the peri-operative and 10-year follow-up periods were evaluated.Results: The total mortality was 5.33% (8/150), including seven early deaths (10.4%) and no late deaths in the C-group, no early deaths (0%) and one late death (1.8%) in the P-group, and no early or late deaths in the T-group. Up to the last follow-up, severe LAVV regurgitation had occurred in 27 patients, including 16 in the C-group, four in the T-group, and seven in the P-group. In total, 12 (12/150, 8.0%) patients received LAVV re-operation, including seven in the C-group, three in the T-group, and two in the P-group. Cox regression analysis showed that pre-operative severe pulmonary hypertension (P=0.006) and severe LAVV regurgitation within 24 hours after the first surgery (P=0.023) were independent risk factors for mortality.≥ Moderate LAVV regurgitation within the first 24 hours after surgery (P=0.014) was an independent risk factor for LAVV re-operation.Conclusions: Complete AVSD repair increased the risk of early death, severe LAVV regurgitation and reoperation. Pre-operative severe pulmonary hypertension and residual severe LAVV regurgitation indicated high risk for mortality. ≥ Moderate LAVV regurgitation within 24 hours after the first surgery predicted a high probability of LAVV re-operation.

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“…One study of 194 patients who underwent AVSD repair at age <3 months between 1990 and 2019 demonstrated improved survival after AVSD repair as a primary procedure. 27 In a propensity-matched cohort, the primary complete repair group had significantly better long-term survival compared with the initial PAB group. Furthermore, the subgroup of neonates who underwent complete repair had no mortality and similar freedom from reoperation compared with age 1 to 3 months.…”

Section: Atrioventricular Septal Defect Surgerymentioning

confidence: 92%

Highlights in congenital cardiothoracic surgery: 2020–2021

Buratto¹,

Konstantinov²

2021

The Journal of Thoracic and Cardiovascular Surgery

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Advances in congenital cardiothoracic surgery continue at a rapid pace. This year, for the first time, the Editorial Board of the Journal provides focused summaries of the key articles published in the American Association for Thoracic Surgery (AATS) journals during the year preceding the annual AATS meeting. These series of focused summaries will be published at the time of the AATS meetings. This particular compendium features articles on 3 topics: aortic valve surgery, the arterial switch operation (ASO), and atrioventricular septal defect (AVSD) repair.

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Early repair of complete atrioventricular septal defect has better survival than staged repair after pulmonary artery banding: A propensity score–matched study

Cited by 21 publications

References 20 publications

Propensity Score Matched Analysis of Cleft Closure in Complete Atrioventricular Septal Defect Repair

Propensity Score Matched Analysis of Cleft Closure in Complete Atrioventricular Septal Defect Repair

Middle to long-term outcomes of surgical repair for atrioventricular septal defect: a single-center study

Highlights in congenital cardiothoracic surgery: 2020–2021

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