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Evaluation of mid-term outcomes of partial and intermediate atrioventricular canal defect surgery

Published online by Cambridge University Press:  14 October 2024

Husnu F. Altin Open the ORCID record for Husnu F. Altin [Opens in a new window] ,
Oktay Korun Open the ORCID record for Oktay Korun [Opens in a new window] ,
Murat Cicek ,
Okan Yurdakok ,
Yigit Kilic Open the ORCID record for Yigit Kilic [Opens in a new window] ,
Arif Selcuk Open the ORCID record for Arif Selcuk [Opens in a new window] ,
Emine Hekim Yilmaz Open the ORCID record for Emine Hekim Yilmaz [Opens in a new window] ,
Selma Oktay Ergin ,
Ahmet Sasmazel  and
Numan A. Aydemir
Husnu F. Altin*
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Oktay Korun
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Murat Cicek
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Okan Yurdakok
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Yigit Kilic
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Arif Selcuk
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Emine Hekim Yilmaz
Affiliation:
Pediatric Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Selma Oktay Ergin
Affiliation:
Pediatric Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Ahmet Sasmazel
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Numan A. Aydemir
Affiliation:
Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
*
Corresponding author: Husnu Firat Altin; Email: [email protected]
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Abstract

Background:

The risk factors for reoperation and mortality after partial and intermediate atrioventricular canal defect repair are unclear. This study assessed the mid-term outcomes and risk factors for reoperation and mortality after partial and intermediate atrioventricular canal defect surgery.

Methods:

Ninety-seven patients who underwent primary repair of intermediate (n = 45) or partial (n = 52) atrioventricular canal defect between 2005 and 2019 were included in this single-centre study.

Results:

The median age was 5 years (2.7–8.9 years). The median follow-up time was 32 months (1.6–90.8 months). The estimated freedom from reoperation at 1, 5, and 10 years was 97%, 91%, and 73%, respectively.

In multivariable analyses, post-operative left atrioventricular valve regurgitation of grade II or higher (odds ratio [OR]: 5.3, 95% confidence interval [CI]: 1.8–15.5, p = 0.01) and post-operative residual intracardiac shunt (OR: 11.6, 95% CI: 1.6–85.8, p = 0.02) were risk factors for reoperation.

In multivariable analyses, perioperative reoperation (OR: 93.4, 95% CI: 3.9–218.7, p = 0.01) and the need for right atrioventricular valve repair (OR: 11.2, 95% CI: 1.0 – 123.3, p = 0.04) were risk factors for mortality. Mortality was higher in patients under 2.6 years of age.

Conclusion:

For patients undergoing repair of partial or intermediate atrioventricular canal defect, those with post-operative left atrioventricular valve regurgitation of grade II or higher and post-operative residual intracardiac shunt have an increased reoperation risk. Higher mortality can be expected after a perioperative reoperation, and in patients requiring right atrioventricular valve repair during the index procedure.

Keywords

Intermediate atrioventricular canal defectpartial atrioventricular canal defectsurgerymortalityreoperation
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 12 , December 2024 , pp. 2610 - 2618
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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Footnotes

Meeting presentation: 19th Turkish Pediatric Cardiology and Cardiac Surgery Congress, Poster Presentation, 23–25 November 2020, Turkey

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