The University of Sydney Children's Hospital at Westmead Clinical School, Sydney, NSW, Australia.
Heart Centre for Children, Children's Hospital at Westmead, Sydney, NSW, Australia.
Interact Cardiovasc Thorac Surg. 2022 Feb 21;34(3):431-437. doi: 10.1093/icvts/ivab263.
There are limited data available on the height of the ventricular component of the septal deficiency (VSD) in patients undergoing complete atrioventricular septal defect (CAVSD) repair. VSD height may influence optimal choice of repair strategy with potential consequences for long-term outcomes. We aimed to measure VSD height using 2-dimensional echocardiography and review its association with postoperative outcomes.
We retrospectively reviewed the preoperative echocardiograms of 45 consecutive patients who underwent CAVSD repair between May 2010 and December 2015 at a single centre. VSD height and left ventricular length on the four-chamber view were measured. Demographic details and early and late outcomes including reoperation and long-term survival were studied.
Twenty patients underwent modified single-patch repair and 25 patients underwent double-patch repair of CAVSD. VSD height in the modified single-patch group ranged from 4.2 to 11.7 mm and in the double-patch group ranged from 5.1 to 14.9 mm. Nine patients had a deep 'scoop' with a VSD height of >10 mm, (7 double patch, 2 modified single patch). VSD height did not correlate with a specific Rastelli classification. There was no significant difference in the VSD height (P = 0.51) or the VSD height-to-left ventricular length ratio (P = 0.43) between the 2 repair groups. There was no 30-day mortality. Eight patients required reoperation; however, VSD height was not a significant predictor of reoperation (hazard ratio 0.95, 95% confidence interval 0.69-1.33; P = 0.08).
There was no correlation between VSD height and risk of reoperation after CAVSD repair. A deep ventricular scoop is uncommon in CAVSD patients.
在接受完全房室间隔缺损（CAVSD）修复的患者中，关于室间隔缺损（VSD）心室成分的高度数据有限。VSD 高度可能会影响最佳的修复策略选择，并对长期结果产生潜在影响。我们旨在使用二维超声心动图测量 VSD 高度，并回顾其与术后结果的关系。
我们回顾性分析了 2010 年 5 月至 2015 年 12 月在一家中心接受 CAVSD 修复的 45 例连续患者的术前超声心动图。测量四腔心视图上的 VSD 高度和左心室长度。研究了人口统计学细节以及早期和晚期结果，包括再次手术和长期生存。
20 例患者接受改良单片修补术，25 例患者接受 CAVSD 双片修补术。改良单片修补组的 VSD 高度范围为 4.2 至 11.7mm，双片修补组的 VSD 高度范围为 5.1 至 14.9mm。9 例患者的 VSD 高度>10mm，存在深“勺状”畸形（7 例双片修补，2 例改良单片修补）。VSD 高度与特定的 Rastelli 分类无关。两组之间的 VSD 高度（P=0.51）或 VSD 高度与左心室长度比值（P=0.43）均无显著差异。无 30 天死亡率。8 例患者需要再次手术；然而，VSD 高度并不是再次手术的显著预测因素（危险比 0.95，95%置信区间 0.69-1.33；P=0.08）。
CAVSD 修复后 VSD 高度与再手术风险之间无相关性。CAVSD 患者中深心室勺状畸形并不常见。
