80. Atrioventricular septal defect and tetralogy of Fallot: A 16-year experience

• Main Authors: S. Al-Ahdal, Y. Al Faraidi, K. Alhawri, N. Albahlooli, A. Al Hossan, J. Al Hadithi, A. Elwy, A. Al Otay, K. Al Najashi, R.M. Di Donato
• Format: Article
• Language: English
• Published: Saudi Heart Association 2015-10-01
• Series: Journal of the Saudi Heart Association
• Online Access: http://www.sciencedirect.com/science/article/pii/S1016731515003206

The choice between primary and staged repair of atrioventricular septal defect with tetralogy of Fallot (AVSD/TOF) is still controversial. We report our surgical experience with this lesion. Methods: Twenty-four patients with AVSD/TOF were repaired between 1997 and 2013. Ten, group 1 (40%), underwent primary repair at a mean age of 29.4 months. Fourteen, group 2 (60%), underwent staged repair at a mean-age of 65.2 months. Mean interval between shunt and repair was 26.5 months. Out of 24 patients, 8 (33%) were repaired by transannular patch, 15 (62%) by pulmonary valve preservation and 1 by pulmonary valve replacement. Results: There was one hospital death in group 2. Mean follow-up period was 70 months. In group 1, 8 patients were alive while 2 were lost to follow-up. Three were re-operated, one for mitral valve repair and left diaphragmatic plication, one for thoracic duct ligation and one for pulmonary valve replacement. In group 2, 10 patients were alive while 3 were lost to follow-up. One developed biventricular outflow obstruction and is awaiting surgery. One had ventricular septal defect device closure. There were 3 reoperations, one for left atrioventricular valve and pulmonary valve replacement, one for pulmonary valve replacement alone and one for relief of biventricular outflow obstruction. All transannular patch patients had dilated right ventricle with moderate to severe tricuspid valve regurgitation. Conclusion: Shunt procedure is a reasonable initial option for many of patients with AVSD/TOF but primary repair can be performed in selected patients with low operative mortality and reasonable morbidity.