Left Atrioventricular Valve Regurgitation After Repair of Complete Atrioventricular Septal Defect

Abstract

IntroductionLeft atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defects.ObjectiveTo determine factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of surgical repair of complete atrioventricular septal defect.MethodsWe assessed the results of 53 consecutive patients 3 years-old and younger presenting with complete 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 atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. Median age was 6.7 months; median weight was 5.3 Kg; 86.8% had Down syndrome. At the time of preoperative evaluation, there were 26 cases with moderate or severe left atrioventricular valve regurgitation (49.1%). Abnormalities on the left atrioventricular valve were found in 11.3%; annuloplasty was performed in 34% of the patients.ResultsAt the time of postoperative evaluation, there were 21 cases with moderate or severe left atrioventricular valve regurgitation (39.6%). After performing a multivariate analysis, the only significant factor associated with moderate or severe left atrioventricular valve regurgitation was the absence of Down syndrome (P=0.03).ConclusionAbsence of Down syndrome was associated with moderate or severe postoperative left atrioventricular valve regurgitation after surgical repair of complete atrioventricular septal defect at our practice.

Long-term results following atrioventricular septal defect repair

“…Because AVSD frequently goes along with Down syndrome (73.8% in our cohort), the role of trisomy 21 as a risk factor for reoperation and mortality following AVSD repair is analyzed in many studies. Interestingly, the absence of Down syndrome is mainly associated with higher degrees of left AV valve regurgitation after repair [ 35 ] leading to higher rates of reoperation [ 18 ]. Patients with Down syndrome were described to need less and later reoperations compared to patients without Down syndrome [ 33 ].…”