Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, SC 29425, USA.
J Thorac Cardiovasc Surg. 2011 Jun;141(6):1371-9. doi: 10.1016/j.jtcvs.2010.08.093. Epub 2010 Dec 15.
We sought to evaluate the contemporary results after repair of a complete atrioventricular septal defect and to determine the factors associated with suboptimal outcomes.
The demographic, procedural, and outcome data were obtained within 1 and 6 months after repair of a complete atrioventricular septal defect in 120 children in a multicenter observational study from June 2004 to 2006.
The median age at surgery was 3.7 months (range, 9 days to 1.1 years). The type of surgical repair was a single patch (18%), double patch (72%), and a single atrial septal defect patch with primary ventricular septal defect closure (10%). The incidence of residual septal defects and the degree of left atrioventricular valve regurgitation (LAVVR) did not differ by repair type. The median interval of intensive care stay were 4 days, ventilation use 2 days, and total hospitalization 8 days. All were independent of the presence of trisomy 21 (80% of the cohort). The in-hospital mortality rate was 2.5% (3/120). The overall 6-month mortality rate was 4% (5/120). The presence of associated anomalies and younger age at surgery were independently associated with a longer hospital stay. The age at repair was not associated with residual ventricular septal defect or moderate or greater LAVVR at 6 months. Moderate or greater LAVVR occurred in 22% at 6 months, and the strongest predictor for this was moderate or greater LAVVR at 1 month (odds ratio, 6.9; 95% confidence interval, 2.2-21.7; P < .001).
The outcomes after repair of complete atrioventricular septal defect did not differ by repair type or the presence of trisomy 21. An earlier age at surgery was associated with increased resource use but had no association with the incidence of residual ventricular septal defect or significant LAVVR.
我们旨在评估完全性房室间隔缺损修复后的当代结果，并确定与不良结果相关的因素。
在 2004 年 6 月至 2006 年期间，一项多中心观察性研究在 120 例儿童中获得了修复完全性房室间隔缺损后 1 至 6 个月的人口统计学、程序和结果数据。
手术时的中位年龄为 3.7 个月（范围为 9 天至 1.1 岁）。手术修复类型为单补丁（18％）、双补丁（72％）和单房间隔缺损补丁合并原发性室间隔缺损关闭（10％）。残余间隔缺损的发生率和左房室瓣反流（LAVVR）的程度不因修复类型而异。重症监护病房停留时间中位数为 4 天，呼吸机使用时间中位数为 2 天，总住院时间中位数为 8 天。这些均与 21 三体（队列的 80％）无关。院内死亡率为 2.5％（3/120）。总的 6 个月死亡率为 4％（5/120）。存在相关畸形和手术时年龄较小与住院时间较长独立相关。修复年龄与 6 个月时残余室间隔缺损或中度或更严重的 LAVVR 无关。6 个月时中度或更严重的 LAVVR 发生率为 22％，1 个月时中度或更严重的 LAVVR 是其最强的预测因素（优势比，6.9；95％置信区间，2.2-21.7；P<.001）。
完全性房室间隔缺损修复后的结果不因修复类型或 21 三体的存在而不同。手术时年龄较小与资源利用增加有关，但与残余室间隔缺损或明显的 LAVVR 发生率无关。
