Repair of partial atrioventricular septal defect in infants: A multi-institutional review

Abstract

Introduction: Partial atrioventricular septal defects (pAVSD) are usually repaired in the preschool years. However, due to significant left atrioventricular valve regurgitation (LAVVR) or congestive heart failure (CHF) repair may be performed in infancy. We performed a multiinstitutional review of outcomes of pAVSD repair in infants to determine long-term clinical outcomes in this group. Methods: From 1980 to 2014, 72 infants (<12 months of age) underwentpAVSDrepair across 3 institutions. Data were obtained fromhospital records and fromgeneral practitioners and cardiologists. Results: Mean age at pAVSD repair was 6.0 ± 3.5 months (median 5.2, range 0.6-11.9), 55.6% (40/72) had CHF and 36.1% (26/72) had moderate or greater LAVVR. Early mortality was 5.6% (4/72). Long-term survival was 84.9% (73.7-91.6%) at 10 years and 78.8% (60.5 - 89.3%) at 20 years follow-up. Cleft closure (HR=0.3, p = 0.04) and older age (HR=0.02, p=0.02) were associated with improved survival on univariate analysis. However, in multivariate analysis age remained a predictor of survival (HR=0.02, p=0.02), while cleft closure was not a significant predictor (HR=0.33, p=0.07). Reoperation was required in 29.2% of patients (21/72) of which, 22.2% (16/72) were LAVV procedures and 9.7% (7/72) were for left ventricular outflow tract obstruction. Permanent pacemakers were required in 6.9% (5/72) of patients. Conclusion: Repair of pAVSD carries a slightly higher risk when performed in infants. Given the higher rates ofCHFand LAVVR in this group, early mortality is low and long-term survival is good.L6127500272016-10-20 <br />