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Replacement of the left atrioventricular valve after repair of atrioventricular septal defect

Published online by Cambridge University Press:  19 August 2008

Keishi Kadoba  and
Richard A. Jonas
Keishi Kadoba
Affiliation:
From the Department of Cardiac Surgery, Children's Hospital and Department of Surgery, Harvard Medical School, Boston
Richard A. Jonas*
Affiliation:
From the Department of Cardiac Surgery, Children's Hospital and Department of Surgery, Harvard Medical School, Boston
*
Dr. Richard A. Jonas, Department of Cardiac Surgery, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 USA
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Summary

A retrospective analysis of 55 patients who underwent replacement of the left atrioventricular valve following surgery for atrioventricular septal defect with separate right and left atrioventricular valves or with a common valvar orifice has revealed a marked decrease in the need for valvar replacement over time. Between 1983 and 1987, the incidence of replacement following repair has been 3% in infants. Overall early mortality for the entire series, extending from 1970 to 1987, was 22%. Mortality in the first year of life was 58%, which was significantly greater than mortality beyond one year of age (14%, p<0.01). Obstruction of the left ventricular outflow tract was a frequent incremental risk factor for death during infancy. The incidence of complete heart block (25%) is disappointingly high, and may reflect distortion of the left atrioventricular junction in an attempt to place as large a prosthesis as possible. The incidence of complete heart block has not decreased with time. These results confirm the desirability of secondary valvoplasty procedures to enable a child to be larger before ultimate replacement of the valve is required.

Type
The World Forum for Pediatric Cardiology Symposium on Atrioventricular Septal Defect
Information
Cardiology in the Young , Volume 1 , Issue 4 , October 1991 , pp. 383 - 389
Copyright
Copyright © Cambridge University Press 1991

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