Repair of Partial Atrioventricular Septal Defect: Age and Outcomes

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Repair of Partial Atrioventricular Septal Defect: Age and Outcomes Paul J. Devlin, MD, Carl L. Backer, MD, Osama Eltayeb, MD, Michael C. Mongé, MD, Amanda L. Hauck, MD, John M. Costello, MD, MPH The Annals of Thoracic Surgery Volume 102, Issue 1, Pages 170-177 (July 2016) DOI: 10.1016/j.athoracsur.2016.01.085 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Operative technique. (A) Saline insufflation is used to assess left atrioventricular (AV) valve and plan closure of zone of apposition. (B) Pericardial patch is sutured in place to close atrial component of defect. This shows completed closure of zone of apposition. (C) Air is removed from left side of heart through suture line before tying knot. Coronary sinus remains draining to right atrium. (CS = coronary sinus; IVC = inferior vena cava; LAVV = left atrioventricular valve; RA = right atrium; RAVV = right atrioventricular valve; RUPV = right upper pulmonary vein; SVC = superior vena cava.) The Annals of Thoracic Surgery 2016 102, 170-177DOI: (10.1016/j.athoracsur.2016.01.085) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Average age for patients who underwent repair of partial atrioventricular septal defect (ASVD) from 1990 to 2014 by 2-year intervals. Patients who were older than 7 years of age at the time of repair were considered late referrals and excluded from this analysis. The Annals of Thoracic Surgery 2016 102, 170-177DOI: (10.1016/j.athoracsur.2016.01.085) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Median postoperative length of stay for patients undergoing partial atrioventricular septal defect (ASVD) repair by age quartile. The median hospital stay was 5 days (quartile 1 = 0–0.75 years, n = 22; quartile 2 = 0.75–1.5 years, n = 21; quartile 3 = 1.5–3.75 years, n = 22; and quartile 4 = >3.75 years, n = 21). The Annals of Thoracic Surgery 2016 102, 170-177DOI: (10.1016/j.athoracsur.2016.01.085) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Number of reoperations for patients who had undergone repair of partial atrioventricular septal defect (ASVD) repair divided into 3 subgroups: left ventricular outflow tract obstruction (LVOTO), left atrioventricular valve regurgitation/left atrioventricular valve stenosis (LAVVR/LAVVS), and pacemaker. Reoperations are subdivided into 4 age quartiles (quartile 1 = 0–0.75 years, n = 22; quartile 2 = 0.75–1.5 years, n = 21; quartile 3 = 1.5–3.75 years, n = 22; quartile 4 = >3.75 years, n = 21). The Annals of Thoracic Surgery 2016 102, 170-177DOI: (10.1016/j.athoracsur.2016.01.085) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Degree of left atrioventricular valve regurgitation (LAVVR) for patients who underwent repair of partial atrioventricular septal defect (AVSD) at most recent echocardiogram. Patients were grouped into 4 age quartiles (quartile 1 = 0–0.75 years, n = 22; quartile 2 = 0.75–1.5 years, n = 21; quartile 3 = 1.5–3.75 years, n = 22; quartile 4 = >3.75 years, n = 21). The Annals of Thoracic Surgery 2016 102, 170-177DOI: (10.1016/j.athoracsur.2016.01.085) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Degree of left atrioventricular valve stenosis (LAVVS) for patients who underwent repair of partial atrioventricular septal defect (AVSD) at most recent echocardiogram. Patients were grouped into 4 age quartiles (quartile 1 = 0–0.75 years, n = 22; quartile 2 = 0.75–1.5 years, n = 21; quartile 3 = 1.5–3.75 years, n = 22; quartile 4 = >3.75 years, n = 21). The Annals of Thoracic Surgery 2016 102, 170-177DOI: (10.1016/j.athoracsur.2016.01.085) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions