Song Lingyun, Ling Yunfei, An Qi
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
J Cardiothorac Surg. 2019 Jun 11;14(1):106. doi: 10.1186/s13019-019-0931-x.
Partial atrioventricular canal defects (PAVC) are preferred to be repaired when diagnosed and before an operation would interfere with school. There were rare previous studies about partial atrioventricular canal defect operations in adult patients. In this single-center retrospective study, we mean to review the mid-term follow-up outcomes of late diagnosed and repaired partial atrioventricular canal defects in adult patients.
46 adult partial atrioventricular canal defect patients who underwent operation in West China Medical Center from 2009 to 2017 were included. Required data were obtained from operation notes, patient charts and the outpatient records.
Among 46 patients, 10(21.7%)were male and mean age at operation was 37.6 ± 12.4 years. 11 patients had prior arrythmia, including 8 atrial fibrillations, 2 atrioventricular blocks and 1 left bundle branch block. There were 41 patients with tricuspid valve regurgitation and 22 underwent tricuspid valvuloplasty. All the patients had mitral regurgitation. 6 patients with valve incrassation and shrinkage underwent mitral valve replacement, and the rest underwent mitral repair surgery. There was one early death post operation and no more mortalities in the following follow-up years. According to the follow-up outcomes, heart function of the patients recovered significantly, dilation of atriums and ventricles, except for left atriums, were reversed to a large extent and all but one patients' tricuspid valve regurgitations were reduced to mild and below. 4(8.7%) patients underwent reoperation and the main reasons were arrythmia and recurrent severe mitral valve regurgitation.
Partial atrioventricular canal defect repair in adult patients can achieve good results. Compared with the results of patients underwent operations in preschool years, though delayed surgery timing seems to bring more preoperative complications and influences heart function, the mortality and reoperation rate are excellent.
部分房室通道缺损（PAVC）一旦确诊，最好在手术影响上学之前进行修复。以往关于成年患者部分房室通道缺损手术的研究很少。在这项单中心回顾性研究中，我们旨在回顾成年患者晚期诊断并修复的部分房室通道缺损的中期随访结果。
纳入2009年至2017年在华西医学中心接受手术的46例成年部分房室通道缺损患者。所需数据从手术记录、患者病历和门诊记录中获取。
46例患者中，男性10例（21.7%），手术时平均年龄为37.6±12.4岁。11例患者既往有心律失常，其中8例为心房颤动，2例为房室传导阻滞，1例为左束支传导阻滞。41例患者有三尖瓣反流，22例接受了三尖瓣成形术。所有患者均有二尖瓣反流。6例瓣膜增厚和收缩的患者接受了二尖瓣置换术，其余患者接受了二尖瓣修复手术。术后有1例早期死亡，在随后的随访年份中无更多死亡病例。根据随访结果，患者的心功能明显恢复，除左心房外，心房和心室的扩张在很大程度上得到逆转，除1例患者外，所有患者的三尖瓣反流均减轻至轻度及以下。4例（8.7%）患者接受了再次手术，主要原因是心律失常和复发性严重二尖瓣反流。
成年患者部分房室通道缺损修复可取得良好效果。与学龄前接受手术的患者结果相比，尽管手术时机延迟似乎会带来更多术前并发症并影响心功能，但死亡率和再次手术率良好。
