Original articlePediatric cardiacReoperations After Repair of Partial Atrioventricular Septal Defect: A 45-Year Single-Center Experience
Section snippets
Patients and Methods
The Mayo Foundation Institutional Review Board approved this study, and all patients or their families gave written informed consent. Between January 1962 and January 2006, 96 patients (63 female) underwent reoperation after initial repair of partial AVSD. At initial repair (50 performed elsewhere), median age was six years (range, 55 days to 64 years). Concomitant cardiac operations included secundum atrial septal defect (ASD) repair in two patients, eccentric tricuspid valve annuloplasty in
Results
The first reoperation at our institution represented the patient's first overall reoperation after initial partial AVSD repair in 82 patients and the patient's second overall reoperation in 14. Operative procedures performed at the first reoperation included LAVV repair in 38 patients or LAVV replacement in 35, subaortic fibrous resection-myectomy in 22, tricuspid valve surgery in 19, ASD rerepair in 11, Konno-modified Konno procedure in 2, and apicoaortic conduit in 1. Intraoperative LAVV
Comment
Reduced operative risk and improved long-term outcome after repair of partial AVSD have been demonstrated since the first reported repair in 1955 [6, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26]. In our series, overall early mortality after the first reoperation was 5.2% (5 of 96); over the last 25 years, early mortality was 2.6% (2 of 78). Further, there were no early deaths after subsequent reoperations (n = 28). In addition to low early mortality, we demonstrate that New
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