Kozak Marcelo Felipe, Kozak Ana Carolina Leiroz Ferreira Botelho Maisano, Marchi Carlos Henrique De, Sobrinho Junior Sirio Hassem, Croti Ulisses Alexandre, Moscardini Airton Camacho
Department of Pediatrics and Pediatric Surgery, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, BR.
Department of Cardiology, Hospital de Base, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, BR.
Rev Bras Cir Cardiovasc. 2015 Jul-Sep;30(3):304-10. doi: 10.5935/1678-9741.20150036.
Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defects.
To determine factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of surgical repair of complete atrioventricular septal defect.
We assessed the results of 53 consecutive patients 3 years-old and younger presenting with complete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. Median age was 6.7 months; median weight was 5.3 Kg; 86.8% had Down syndrome. At the time of preoperative evaluation, there were 26 cases with moderate or severe left atrioventricular valve regurgitation (49.1%). Abnormalities on the left atrioventricular valve were found in 11.3%; annuloplasty was performed in 34% of the patients.
At the time of postoperative evaluation, there were 21 cases with moderate or severe left atrioventricular valve regurgitation (39.6%). After performing a multivariate analysis, the only significant factor associated with moderate or severe left atrioventricular valve regurgitation was the absence of Down syndrome (P=0.03).
Absence of Down syndrome was associated with moderate or severe postoperative left atrioventricular valve regurgitation after surgical repair of complete atrioventricular septal defect at our practice.
左房室瓣反流是房室间隔缺损手术矫正后最令人担忧的残留病变。
确定完全性房室间隔缺损手术修复后30天内发生中度或重度左房室瓣反流的相关因素。
我们评估了2002年至2010年期间在我们科室接受手术的53例3岁及以下完全性房室间隔缺损患者的结果。考虑了以下变量：年龄、体重、无唐氏综合征、术前左房室瓣反流程度、左房室瓣异常以及瓣环成形术的使用情况。中位年龄为6.7个月；中位体重为5.3千克；86.8%的患者患有唐氏综合征。术前评估时，有26例患者存在中度或重度左房室瓣反流（49.1%）。发现11.3%的患者存在左房室瓣异常；34%的患者进行了瓣环成形术。
术后评估时，有21例患者存在中度或重度左房室瓣反流（39.6%）。进行多因素分析后，与中度或重度左房室瓣反流相关的唯一显著因素是无唐氏综合征（P=0.03）。
在我们科室，无唐氏综合征与完全性房室间隔缺损手术修复后术后中度或重度左房室瓣反流相关。
