Effect and Risk Factor Analysis for Complete Atrioventricular Septal Defect
MA Hao1, WANG Lixin2, XUE Yan2, SHI Haiyan2, XU Dong1
1. Department of Cardiovascular Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 2. Department of Cardiovascular Surgery, The Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Abstract：Objective To summary operative characteristics and evaluate the risk factors for correction of complete atrioventricular septal defect(CAVSD)in order to improve the surgical treatment.Methods We reviewed the information of 152 consecutive patients who underwent the correction of CAVSD from 2009 to 2018.The patients were divided into two groups based on post-operative vicious complications The effect of operation and the risk factors for the early post-operative death and vicious complications were analyzed by Logistic regression analysis.Results 18 patients(11.8% ) suffered from vicious complications at the early post-operative stage, including 6 patients low cardiac output syndrome, 4 patients pulmonary hypertensive crisis,4 patients capillary leak syndrome,2 patients ventricular septal defect(diameter≥5 mm),one patient Ⅱ°Ⅱ type atrioventricular block. The statistic analysis indicated that age(OR=1.063,95%CI 1.406-1.082), pulmonary artery systolic pressure(OR=1.038,95%CI 1.012-1.070),left atrioventricular valve regurgitation(OR=1.296,95%CI 1.193-1.387)and aortic cross clamp time(OR=1.172,95%CI 1.008-1.352) were the high risk factors for vicious complications(P<0.05).Conclusions To improve the effect of operation, we can choose appropriate age at the time of surgery, reduce pulmonary arterial hypertension, use reasonable surgical procedure and protect atrio-ventricular valve.
Fong L S, Winlaw D S, Orr Y. Is the modified single-patch repair superior to the double-patch repair of complete atrioventricular septal defects?[J] . Interact Cardiovasc Thorac Surg, 2019, 28(3): 427- 431.
[7]
Cui H, Nie Z, Ou Y, et al. Early and midterm outcomes of a modified single-patch technique for repairing complete atrioventricular septal defect in children and adults [J]. J Card Surg, 2020, 35(1): 75-82.
[8]
Fong L S, Betts K, Kannekanti R, et al. Modified-single patch vs. double patch repair of complete atrioventricular septal defects[J].Semin Thorac Cardiovasc Surg, 2020, 32(1): 108-116.
[9]
Airaksinen R, Mattila I, Jokinen E, et al. Complete atrioventricular septal defect: evolution of results in a single center during 50 years [J].Ann Thorac Surg, 2019, 107(6): 1824-1830.
[10]
St Louis J D, Jodhka U, Jacobs J P,et al. Contemporary outcomes of complete atrioventricular septal defect repair: analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database[J].J Thorac Cardiovasc Surg, 2014, 148(6):2526-2531.
[11]
Houck C A, Evertz R, Teuwen C P, et al. Dysrhythmias in patients with a complete atrioventricular septal defect: From surgery to early adulthood [J]. Congenit Heart Dis, 2019, 14(2): 280-287.
[12]
Houck C A, Evertz R, Teuwen C P, et al. Dysrhythmias in patients with a complete atrioventricular septal defect: From surgery to early adulthood[J]. Congenit Heart Dis, 2019, 14(2): 280-287.
Bush D, Galambos C, Ivy D D, et al. Clinical characteristics and risk factors for developing pulmonary hypertension in children with down syndrome [J]. J Pediatr, 2018, 202(2): 212-219.
[15]
Tumanyan M R, Filaretova O V, Chechneva V V, et al. Repair of complete atrioventricular septal defect in infants with down syndrome: outcomes and long-term results [J]. Pediatr Cardiol, 2015, 36(1): 71-75.
2021, Vol. 32 
