Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study.
Atrioventricular canal
Congenital heart defects
Outcomes
Surgery
Journal
Journal of Yeungnam medical science
ISSN: 2799-8010
Titre abrégé: J Yeungnam Med Sci
Pays: Korea (South)
ID NLM: 9918333886606676
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
17
10
2022
accepted:
09
12
2022
medline:
2
2
2023
pubmed:
2
2
2023
entrez:
1
2
2023
Statut:
ppublish
Résumé
This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique.
METHODS
METHODS
This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique.
RESULTS
RESULTS
The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01).
CONCLUSION
CONCLUSIONS
A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.
Identifiants
pubmed: 36721320
pii: jyms.2022.00759
doi: 10.12701/jyms.2022.00759
pmc: PMC10076926
doi:
Types de publication
Journal Article
Langues
eng
Pagination
187-192Références
Mayo Clin Proc. 1966 May;41(5):296-308
pubmed: 5932615
J Thorac Cardiovasc Surg. 1999 Oct;118(4):642-6
pubmed: 10504628
Ann Thorac Surg. 2015 May;99(5):1671-5; discussion 1675-6
pubmed: 25825201
Thorac Cardiovasc Surg. 2021 Dec;69(S 03):e68-e75
pubmed: 34953470
Congenit Heart Dis. 2019 Mar;14(2):280-287
pubmed: 30485659
World J Pediatr Congenit Heart Surg. 2022 May;13(3):371-375
pubmed: 35446220
Transl Pediatr. 2018 Apr;7(2):91-103
pubmed: 29770291
Ann Pediatr Cardiol. 2009 Jan;2(1):51-4
pubmed: 20300269
Cardiol Young. 2020 Jan;30(1):1-11
pubmed: 31910934
Ann Thorac Surg. 1997 Aug;64(2):487-93; discussion 493-4
pubmed: 9262599
Pediatr Cardiol. 2018 Dec;39(8):1590-1597
pubmed: 29948031
Cardiol Young. 2022 Jun;32(6):869-873
pubmed: 34350818
J Thorac Cardiovasc Surg. 2015 Aug;150(2):369-74
pubmed: 26048271