Samanidis George, Kostopanagiotou Konstantinos, Kanakis Meletios, Kourelis Georgios, Kolovou Kyriaki, Vagenakis Georgios, Bobos Dimitrios, Giannopoulos Nicholas
Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.
Department of Paediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece.
J Yeungnam Med Sci. 2023 Apr;40(2):187-192. doi: 10.12701/jyms.2022.00759. Epub 2023 Feb 1.
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.
本研究旨在呈现采用单片技术修复完全性房室通道缺损（CAVC）后的短期和中期结果。
本研究纳入了30例采用单片技术接受CAVC手术矫正的儿童。
患者的中位年龄为5.7个月（四分位间距[IQR]，5.0 - 7.5个月），23例患者（76.7%）为A型CAVC。14例患者（46.7%）为女性，17例（56.7%）被诊断为唐氏综合征。住院死亡率为0%。在中位随访4年（IQR，3.5 - 5.0年）期间未观察到死亡病例。无唐氏综合征的患者与晚期中度二尖瓣反流（MR）相关（p = 0.02）。随访2年、4年和5年后，分别有96.6%、78.5%和50%的患者出现程度小于中度的晚期MR，而随访2年、4年和6年后，分别有96.7%、85.9%和59.0%的患者出现程度小于中度的晚期三尖瓣反流。中位随访4年后，只有1例患者因左心室流出道梗阻需要手术修复，该情况发生在首次手术后26个月。对CAVC类型、性别、唐氏综合征、年龄和体重进行多变量逻辑回归分析显示，无唐氏综合征是晚期中度MR（MR - 2）的危险因素（比值比，0.05；95%置信区间，0.006 - 0.50；p = 0.01）。
用于CAVC手术修复的单片技术是一种安全的方法，短期和中期结果可接受。
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