Surgical outcomes in the treatment of children with atrioventricular septal defects

Objective: We analyzed retrospectively the preoperative, operative, and postoperative events and their effect on the surgical outcomes in patients with atrioventricular septal defect (AVSD). Methods: Between 1997 and 2007, 110 patients underwent surgical repair of atrioventricular septal defect, only10 patients had previously palliative procedures. The median age at operation was 7.2 months (3 months- 19.8 years). 25 patients with unbalanced left ventricle (22.7%), and 74 patients associated with Down syndrome (67.3%). Two-patch technique was used in 81 patients (73.6%), including 6 patients with RVOTO, while single- patch technique in 29 patients (26.4%). Results: Five patients underwent early postoperative revision (4.6%). Four of these were due to severe mitral insufficiency, and one due to sub-aortic obstruction. Six patients required pacemaker implantation (5.7%). Only 1 patient with Down syndrome had postoperatively complete AV block (1.4%). In the follow-up period 93.3% of patients had sinus rhythm. Early mortality was 1 patient (0.9%), due to right heart failure. There was no late mortality. The follow- up was complete for 105 patients (96.3%), the mean follow-up time was 3.5 years±3.2 years. Twenty-nine reoperations in 22 patients (20.1%) were performed (6 MV replacements, 12 MV repairs, 7 LVOTO repairs, 1 VSD occluder implantation, 1 PDA closure by colis and 2 heart transplantations). The freedom from reoperation at 10 years for all patients was 80%. Conclusions: Our data show that the surgical repair of patients with atrioventricular septal defect carries low morbidity and low mortality with good clinical and functional status.