Post-operative left atrioventricular valve function after the staged repair of complete atrioventricular septal defect with tetralogy of Fallot.

Abstract

OBJECTIVE:

This study reviewed surgical outcomes of staged repair for complete atrioventricular septal defect with tetralogy of Fallot, especially with focusing on the post-operative left-sided atrioventricular valve function.

METHODS:

Between 1992 and 2013, 10 patients with complete atrioventricular septal defect with tetralogy of Fallot underwent total correction by the following surgical strategy. Systemic-to-pulmonary shunt was placed at first at the mean age of 1.5 ± 1.3 months. Then confirming sufficient development of the left heart structures, the total correction was performed at the mean age of 1.4 ± 0.6 years. Second shunt was required in 4 (40 %) patients to develop the left heart structures.

RESULTS:

The left ventricular end-diastolic volume before total correction was 127 ± 30 % of normal size. The two-patch repair was applied in 8 (80 %) patients. There was no mortality, and 1 reoperation case for left-sided atrioventricular valve regurgitation. The follow-up was completed on all patients and the mean follow-up period was 7.4 ± 7.0 years. The post-operative left-sided atrioventricular valve regurgitation kept less than moderate for 10-year follow-up in all patients except one patient who required the repair of left-sided atrioventricular valve 1 year after the total correction.

CONCLUSIONS:

The post-operative left-sided atrioventricular valve function after the repair of complete atrioventricular septal defect with tetralogy of Fallot maintained with the application of the two-patch repair, early and repeated palliative systemic-to-pulmonary shunt, and the early definitive surgery.

• Authors: Kazuki Morimoto, Takaya Hoashi, Koji Kagisaki, Kenichi Kurosaki, Isao Shiraishi, Hajime Ichikawa
• Journal: General thoracic and cardiovascular surgery (Gen Thorac Cardiovasc Surg) Vol. 62 Issue 10 Pg. 602-7 (Oct 2014) ISSN: 1863-6713 [Electronic] Japan
• PMID: 24803092 (Publication Type: Journal Article)

Topics

• Cardiac Surgical Procedures (mortality)
• Female
• Heart Septal Defects
• Humans
• Infant
• Male
• Mitral Valve Insufficiency (physiopathology, surgery)
• Postoperative Care
• Reoperation (statistics & numerical data)
• Retrospective Studies
• Stroke Volume (physiology)
• Tetralogy of Fallot (physiopathology, surgery)
• Treatment Outcome
• Ventricular Function, Left (physiology)