scholarly journals Repair of Atrioventricular Septal Defect and Transposition in Left Isomerism

2017 ◽  
Vol 103 (4) ◽  
pp. e353-e355 ◽  
Author(s):  
Kenji Suzuki ◽  
Mitsuru Aoki ◽  
Ikuo Hagino ◽  
Tomohiro Saito ◽  
Ryogo Hoki ◽  
...  
Keyword(s):  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Left Isomerism

Spectrum and outcome of atrioventricular septal defect in fetal life

2002 ◽  
Vol 12 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Vlasta Fesslova ◽  
Laura Villa ◽  
Simona Nava ◽  
Chiara Boschetto ◽  
Carla Redaelli ◽  
...  
Keyword(s):  
Atrioventricular Block ◽  
Septal Defect ◽  
Complex Form ◽  
Atrioventricular Septal Defect ◽  
Favourable Outcome ◽  
Trisomy 13 ◽  
Chromosomal Anomalies ◽  
Fetal Life ◽  
Atrioventricular Septal Defects ◽  
Left Isomerism

Objectives of the study: to analyse the features and outcomes of different types of atrioventricular septal defects, detected during fetal life, as compared to postnatal data. Material and methods: We analysed retrospectively the data concerning 82 fetuses with atrioventricular septal defect, diagnosed from 19 through 37 weeks gestation with a median of 26 weeks. In 46 cases (56.1%), the diagnosis has been made before the age of 24 weeks. Results: Characteristics of the series – in 44 fetuses the atrioventricular septal defect was not associated with other cardiac anomalies, while 38 fetuses had a more complex form. Chromosomal anomalies were present in 33 of the fetuses (40.2%), more frequently in cases without associated intracardiac defects (56.8%). Trisomy 21 occurred in just over one quarter the series, and in 43.2% of cases without associated defects. In addition, 11% of fetuses had trisomy 18, and one had trisomy 13. Extracardiac anomalies were present in 12 of the fetuses (14.6%), more frequently in cases without associated abnormalities. Of fetuses with more complex defects, 46.4% had hypoplasia of the left ventricle and aorta. Complete atrioventricular block was present in 10 of the fetuses (12.2%), mainly in fetuses with other malformations, and particularly with left isomerism. Recurrence of congenital heart disease was observed in 5 of the fetuses (6.1%). Outcome: In 25 instances (30.5%) the parents opted for termination of pregnancy. Of 57 cases that continued through pregnancy, 9 fetuses died prior to term (15.8%), 32 died postnatally (56.13%) and only 16 fetuses (28.1%) survived. Overall, the mortality was higher in cases with associated malformations, in those with heart failure or those with atrioventricular block. Cardiac surgery was performed in 19 infants, with 5 dying postoperatively, and one late. Conclusions: Our data show a high prevalence of atrioventricular septal defect associated with other malformations when diagnosed during fetal life. This combination is less frequently associated with chromosomal and extracardiac anomalies, but more often with obstructive lesions of the left heart and with atrioventricular block. The association results in a less favourable outcome.

scholarly journals Surgical Management of Hearts with Isomeric Atrial Appendages

2022 ◽  
Author(s):  
Ujjwal Chowdhury ◽  
Robert Anderson ◽  
Diane E. Spicer ◽  
Lakshmi Sankhyan ◽  
Niraj Pandey ◽  
...  
Keyword(s):  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Double Outlet Right Ventricle ◽  
Surgical Approaches ◽  
Caval Vein ◽  
Inferior Caval Vein ◽  
Left Isomerism ◽  
Right Isomerism ◽  
Pulmonary Arterial ◽  
Anomalous Pulmonary Venous Connection

Background and aim: On the basis of previously published accounts, coupled with our own experience, we have assessed the surgical approaches to patients with isomeric atrial appendages. Methods: We reviewed pertinent published studies on surgical treatment of individuals with isomeric atrial appendages, with the pertinent surgical details provided by most of the manuscripts. Results: Half of patients with right isomerism, and two-thirds of those with left isomerism have bilateral superior caval veins. Azygos extension of the inferior caval vein is reported in three-quarters of those with left isomerism. The coronary sinus is universally absent in right isomerism, along with totally anomalous pulmonary venous connection, and is absent in two-fifths of those with left isomerism.. Univentricular atrioventricular connections are expected in up to three-quarters of those with right isomerism. Atrioventricular septal defect is reported in up to four-fifths, more frequently in right isomerism, with such patients typically having discordant ventriculoatrial connections or double outlet right ventricle. Reported mortalities extend to 85% for those with right, and 50% for those with left isomerism. In right isomerism, mortality is up to 54% for systemic-to-pulmonary arterial shunting, up to 75% for univentricular repair, and up to 95% for repair of totally anomalous pulmonary venous connection itself. No more than one-quarter had undergone Fontan completion, with reported mortalities of 21%. Conclusion: Early surgical results are satisfactory in patients with left isomerism, but disappointing for those with right. Recent advances in cardiac and liver transplantation may offer improved survival.

Improved results of corrective repair for complete atrioventricular septal defect

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
M Ono ◽  
H Görler ◽  
D Böthig ◽  
M Westhoff-Bleck ◽  
A Haverich ◽  
...  
Keyword(s):  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Complete Atrioventricular Septal Defect ◽  
Complete Atrioventricular

EARLY OUTCOME AFTER AORTIC VALVE REPLACEMENT ON PATIENTS WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION

2014 ◽  
pp. 31-36
Author(s):  
Quang Thuu Le
Keyword(s):  
Septal Defect ◽  
Intraoperative Complications ◽  
Systolic Pressure ◽  
Atrioventricular Septal Defect ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Mitral Insufficiency ◽  
Atrioventricular Valve ◽  
Ventricular Ejection Fraction ◽  
Mitral Incompetence

Background: To evaluate the early results of operation for partial atrioventricular septal defect. Methods: Twenty-sevent patients underwent surgical correction of partial atrioventricular septal defect from 1/2011 to 12/2013 at Cardiovascular Centre of Hue Central Hospital. There were 7 (25.9%) female patients and 20 (74.1%) male patients, 18.5% of patients aged < 1 age, 55.6% of patients aged ≥ 1 to 15 years, and 25.9% of patients aged ≥ 16 to 60 years. Sevent (25.9%) had congestive heart failure. There was a primum atrial septal defect in 100% of patients. A cleft of the anterior mitral leaflet was diagnosed in 100% of patients. 92.6% of patients had either moderate or severe mitral incompetence prior to operation. The pulmonary artery systolic pressure exceeded 40 mmHg in 85,.2% of patients. Results: Atrial septal defects were closed with a pericardial patch in 100% of patients. The cleft in its anterior leaflet was closed in 100% of patients. Postoperatively, moderate mitral insufficiency developed in 14.8% of patients. 85.2% of patients have mild mitral incompetence. One patients (3.7%) needed a permanent pacemaker. There was no intraoperative mortality. At 6-9 months postoperatively, left atrioventricular valve insufficiency was moderate in 2 (7.4%) patients and mild in 25 (92.6%) patients who had had cleft closure alone. Conclusions: Repair of partial atrioventricular septal defect is safe and good. It is important to close the cleft in the left atrioventricular valve. The mitral valve should be repaired in a conservative manner. Intraoperative complications occur but are uncommon, suggesting that short-term follow is excellent.

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