Treatment of Isolated Complete Atrioventricular Septal Defect: The Hue Central Hospital Experience

• Main Authors: Xuan NT, Hung NX, An TH, Phuoc ND, Son NH, Hiep PN
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-06-01
• Series: Open Access Surgery
• Subjects: complete atrioventricular septal defect; repair; outcome
• Online Access: https://www.dovepress.com/treatment-of-isolated-complete-atrioventricular-septal-defect-the-hue--peer-reviewed-article-OAS

Nguyen Thanh Xuan,1 Nguyen Xuan Hung,2 Tran Hoai An,2 Nguyen Dang Phuoc,2 Nguyen Huu Son,3 Pham Nhu Hiep1 1Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, Hue City, Vietnam; 2Department of Cardiovascular Surgery, Cardiovascular Center, Hue Central Hospital, Hue City, Vietnam; 3Department of Pediatric Neurology, Pediatric Center, Hue Central Hospital, Hue City, VietnamCorrespondence: Nguyen Thanh XuanDepartment of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, 16 Le Loi Street, Hue City 530000, VietnamTel [phone]Email [e-mail]: Complete atrioventricular septal defect is a complex cardiac malformation characterized by an ostium primum atrial septal defect, a common atrioventricular valve, and a variable deficiency of the ventricular septum inflow. The left AV valve and right AV valve have no clear division. The treatment of complete atrioventricular septal defects has evolved in recent decades, but it remains challenging. This retrospective study evaluated early and late outcomes in patients undergoing surgery at a single heart center.Patients and Methods: We retrospectively evaluated outcomes in 52 complete atrioventricular septal defect patients undergoing definitive repair from January 2016 to January 2018. All patients were repaired with either the classic one-patch technique or the two-patch technique.Results: The mean age at operation was 4.12 ± 0.26 months (2 months– 3 years). Forty cases (76.9%) included in the study have Down’s syndrome. After the operation, the atrioventricular valve showed marked improvement, and pulmonary artery pressure tended to decrease when compared with preoperative levels. Arrhythmias in two cases with 3rd-degree AV block required permanent pacing (3.8%). In-hospital mortality was observed in 1/52 (1.9%) of patients. The 3-year overall survival rate after repair was 98.1%. No significant difference was found between the two groups.Conclusion: The surgical repair of complete atrioventricular septal defects demonstrated excellent results at a very early age and even in the case of Down’s syndrome.Keywords: complete atrioventricular septal defect, repair, outcome