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房室间隔缺损修复的结果:阿根廷科尔多瓦两家机构的10年经验

Outcomes of Atrioventricular Septal Defect Repair: Two-Institutions, 10-Year Experience in Cordoba, Argentina.

作者信息

Juaneda Ignacio, Pizzulli Lucca, Ferrari Paula, Molinas Rodrigo, Diaz Juan, Azar Irma, Allub Alejandro, Juaneda Ernesto, Louis James St, Peirone Alejandro, Kathy Jenkins

机构信息

Congenital Heart Surgery, Hospital Privado Universitario de Cordoba. Hospital de Niños de Cordoba, Cordoba, Argentina.

Pediatric Cardiology, Hospital de Niños de Cordoba, Cordoba, Argentina.

出版信息

World J Pediatr Congenit Heart Surg. 2025 Jul;16(4):509-515. doi: 10.1177/21501351241305135. Epub 2025 Jan 30.

Abstract

BackgroundOutcomes following surgical repair of atrioventricular septal defect have improved over the last decades. Global mortality for repair of this defect is approximately 3.5%. We describe contemporary surgical outcomes from two institutions in Argentina.Material and MethodsA retrospective two-institution review was performed of patients operated on for atrioventricular septal defect (partial, transitional, and complete) at Hospital Privado Universitario de Cordoba and Hospital de Niños Cordoba, from January 2014 to December 2023. We analyzed demographic characteristics, operative data, mortality, and outcomes.ResultsOne hundred and ten patients were operated for atrioventricular septal defect: There were 78 patients with complete atrioventricular septal defect, 10 with partial atrioventricular septal defect, and 22 with transitional atrioventricular septal defect. Mean age and weight at operation were 1.17 year (range 0.04-13 years) and 7.53 kg (2.8-55 kg), respectively. For the complete atrioventricular septal defect subgroup, surgeries with the modified single patch technique had shorter cardiopulmonary bypass times when compared with the two patch technique (95.6 vs 139.7 min, respectively,  < .001). Hospital mortality was 4.5% (5 of 110 patients), all with complete atrioventricular septal defect operated with the double patch technique. Mean follow-up of the entire cohort was 57.4 months (1-118 months). Five patients underwent a reoperation at a mean time from the first operation of 14.4 months (6-24 months).ConclusionsAtrioventricular septal defect surgical repair was successfully achieved in different ages and anatomical subtypes in most patients. Complete atrioventricular septal defect had higher mortality when compared with other subgroups. Our review shows similar outcomes following repair of atrioventricular septal defect compared with an international aggregate in a resource-limited practice.

摘要

背景

在过去几十年中,房室间隔缺损手术修复后的预后有所改善。该缺损修复的全球死亡率约为3.5%。我们描述了阿根廷两家机构的当代手术预后情况。

材料与方法

对2014年1月至2023年12月在科尔多瓦私立大学医院和科尔多瓦儿童医院接受房室间隔缺损(部分型、过渡型和完全型)手术的患者进行了一项回顾性双机构研究。我们分析了人口统计学特征、手术数据、死亡率和预后情况。

结果

110例患者接受了房室间隔缺损手术:其中78例为完全性房室间隔缺损,10例为部分性房室间隔缺损,22例为过渡性房室间隔缺损。手术时的平均年龄和体重分别为1.17岁(范围0.04 - 13岁)和7.53千克(2.8 - 55千克)。对于完全性房室间隔缺损亚组,与双补片技术相比,采用改良单补片技术的手术体外循环时间更短(分别为95.6分钟和139.7分钟,P < 0.001)。医院死亡率为4.5%(110例患者中有5例),均为采用双补片技术进行手术的完全性房室间隔缺损患者。整个队列的平均随访时间为57.4个月(1 - 118个月)。5例患者在首次手术后平均14.4个月(6 - 24个月)接受了再次手术。

结论

大多数患者在不同年龄和解剖亚型中成功实现了房室间隔缺损的手术修复。与其他亚组相比,完全性房室间隔缺损的死亡率更高。我们的研究表明,在资源有限的情况下,与国际总体情况相比,房室间隔缺损修复后的预后相似。

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