Zhang Han, Li Gang, Sun Jiashu, Zuo Yansong, Wang Qiang
Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Ann Med. 2025 Dec;57(1):2556262. doi: 10.1080/07853890.2025.2556262. Epub 2025 Sep 12.
To assess the results after repair of atrioventricular septal defect (AVSD) in adult patients in our centre.
We assessed 168 patients who received AVSD repair at a single institution from 2013 to 2023. Relevant data were obtained from medical and surgical records, and focused on the early and long-term results.
Median age at surgery was 36.4 (27.0-47.8) years. One hundred and forty-seven patients (87.5%) with partial AVSD, 15 patients (8.9%) with intermediate AVSD and six patients (3.6%) with complete AVSD. Left atrioventricular valve (LAVV) regurgitation was present in 160 patients; the LAVV clefts were closed completely in 155 patients (92.3%), of which 36 (21.4%) underwent mitral valve ring annuloplasty and 18 (10.7%) patients underwent additional implantation of an incomplete flexible band into the LAVV. There were two early deaths, with two deaths over a median follow-up of 36.0 (14.0-60.0) months. According to the follow-up outcomes, the heart measurement, pulmonary artery pressure and valve regurgitations recovered significantly. A total of 34 patients underwent 37 reoperations. The majority of subsequent reoperations were performed because of residual LAVV pathology ( = 6, 16.2%), and arrhythmias ( = 31, 91.2%). Competing risks analysis revealed that 10 years after the initial operation, 2.6% had died without reintervention, 23.3% had received reintervention and 74.7% were alive without reintervention.
AVSD in adult patients can be done safely with low early mortality and good long-term out-comes. While the reoperation rate is minimal, it is important to closely monitor the significant occurrence of arrhythmias.
评估本中心成年患者房室间隔缺损（AVSD）修复术后的结果。
我们评估了2013年至2023年在单一机构接受AVSD修复的168例患者。从医疗和手术记录中获取相关数据，并重点关注早期和长期结果。
手术时的中位年龄为36.4（27.0 - 47.8）岁。147例（87.5%）为部分型AVSD，15例（8.9%）为中间型AVSD，6例（3.6%）为完全型AVSD。160例患者存在左房室瓣（LAVV）反流；155例（92.3%）患者的LAVV瓣裂完全闭合，其中36例（21.4%）接受了二尖瓣环成形术，18例（10.7%）患者在LAVV中额外植入了不完全柔性带。有2例早期死亡，在中位随访36.0（14.0 - 60.0）个月期间有2例死亡。根据随访结果，心脏测量、肺动脉压力和瓣膜反流明显恢复。共有34例患者接受了37次再次手术。随后的大多数再次手术是由于残留的LAVV病变（n = 6，16.2%）和心律失常（n = 31，91.2%）。竞争风险分析显示，初次手术后10年，2.6%的患者未进行再次干预死亡，23.3%的患者接受了再次干预，74.7%的患者未进行再次干预存活。
成年患者的AVSD修复手术可以安全进行，早期死亡率低，长期预后良好。虽然再次手术率很低，但密切监测心律失常的显著发生很重要。
