scholarly journals Surgical Management of Complete Atrioventricular Septal Defect with Tetralogy of Fallot

2014 ◽  
Vol 20 (5) ◽  
pp. 341-346 ◽  
Author(s):  
Renjie Hu ◽  
Haibo Zhang ◽  
Zhiwei Xu ◽  
Jinfen Liu ◽  
Zhaokang Su ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Surgical Management ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Complete Atrioventricular Septal Defect ◽  
Complete Atrioventricular

Surgical management of complete atrioventricular septal defect with tetralogy of Fallot: results from a national audit database

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Dorobantu ◽  
R Tulloh ◽  
S Stoica
Keyword(s):  
Tetralogy Of Fallot ◽  
Surgical Management ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
National Audit ◽  
Treatment Pathways ◽  
Complete Atrioventricular Septal Defect ◽  
Complete Repair ◽  
Complete Atrioventricular

Abstract Background Complete atrioventricular septal defect (CAVSD) with tetralogy of Fallot (CAVSD-ToF) is an uncommon association, and the management is more difficult than for each lesion in isolation. Depending on the anatomy, clinical status and ventricular morphology, definitive repair is offered either as staged or single operation with few undergoing single or one and a half ventricle procedures. Currently available data are limited to single centre studies. Purpose We aim to use data from a national audit dataset to describe outcomes in the surgical management of CAVSD-ToF with data from the national audit. Methods All children with CAVSD and tetralogy of Fallot (including double outlet right ventricle and pulmonary atresia variants) undergoing the first cardiac procedure between 2000–2013 were included and all subsequent procedures extracted. Three treatment pathways were defined: definitive primary procedure (“primary complete repair”), staged repair or “unbalanced ventricles repair” (Glenn shunt or modified Fontan). Continuous data is expressed as median (range). Survival data obtained using the Kaplan Meier method and subgroup comparisons done using the log-rank test. Results A total of 125 patients were included, 50.4% male, first procedure at 150 (1–2770) days. Down syndrome was present in 79.4% (63/79 of those with reported non-cardiac comorbidities), while 8% (10/125) had heterotaxy syndrome. “Primary complete repair” was performed in 40% (n=50), at 319 (33–2770) days. Staged repair was undertaken in 28% (n=35), first palliation at 80 (1–733) days. An “unbalanced ventricles” approach was used in 16.8% (n=21), first procedure at 135 (1–1742) days). The other 15.2% (n=19), first procedure at 53 (range 1–436) days, had at least one palliation procedure, but no identifiable committed pathway. Survival at 5 years from the first procedure in “primary complete repair” compared to the remainder of the group is shown in the Figure. No significant differences in survival were found. Specifically in the “unbalanced ventricle repair” group, just 1 patient died during follow-up. A total of 85 patients (68%) achieved either primary or staged “complete repair”. Early mortality (30 day) after the “complete repair” was 6.6% (similar for both approaches, p=0.9). Survival at 5 years after “complete repair” was 82.7% (similar for both approaches, p=0.8). Freedom from any cardiac re-intervention at 5 years was 69.5% (77.6% after primary, 58.1% after staged repair, p=0.03). Conclusion Early-life mortality in this heterogeneous group of CAVSD-ToF remains high, even in patients receiving definitive “complete repair”. We found no survival differences in the medium term between primary repair and a palliation approach, but more cardiac re-interventions were undertaken after staged complete repair. Surprisingly good results were seen in the unbalanced ventricles group, but longer follow up is needed to examine their attrition and longer term outcome. Survival at 5 years by treatment option Funding Acknowledgement Type of funding source: None

scholarly journals Complete atrioventricular septal defect with tetralogy of Fallot: diagnosis and management.

Heart ◽  
1994 ◽  
Vol 71 (6) ◽  
pp. 579-583 ◽  
Author(s):  
M. A. Gatzoulis ◽  
D. Shore ◽  
M. Yacoub ◽  
E. A. Shinebourne
Keyword(s):  
Tetralogy Of Fallot ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Diagnosis And Management ◽  
Complete Atrioventricular Septal Defect ◽  
Complete Atrioventricular

Repair of Complete Atrioventricular Septal Defect with Tetralogy of Fallot:

2004 ◽  
Vol 19 (2) ◽  
pp. 175-183 ◽  
Author(s):  
Edvin Prifti ◽  
Massimo Bonacchi ◽  
Massimo Bernabei ◽  
Marzia Leacche ◽  
Fabio Bartolozzi ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Complete Atrioventricular Septal Defect ◽  
Complete Atrioventricular

Repair of complete atrioventricular septal defect with tetralogy of Fallot

1990 ◽  
Vol 50 (3) ◽  
pp. 407-412 ◽  
Author(s):  
Michel Ilbawi ◽  
Christopher Cua ◽  
Serafin DeLeon ◽  
Alex Muster ◽  
Milton Paul ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Complete Atrioventricular Septal Defect ◽  
Complete Atrioventricular

Surgical management with mitral valve replacement in young infants with congenital mitral valve diseases and complete atrioventricular septal defect

2008 ◽  
Vol 149 (40) ◽  
pp. 1891-1894
Author(s):  
István Hartyánszky ◽  
Sándor Mihályi ◽  
Gábor Bodor
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Surgical Management ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Young Infants ◽  
Complete Atrioventricular Septal Defect ◽  
Valve Diseases ◽  
Complete Atrioventricular

A szerzők célja volt csecsemőkorban vizsgálni a veleszületett mitralisbillentyű-szűkület és -elégtelenség sebészi kezelését, valamint a komplett atrioventricularis septumdefektus (CAVD) teljes korrekciója során a mitralis billentyű kialakításának, pótlásának lehetőségét. Betegek: 2001 és 2007 között 82, egy évnél fiatalabb csecsemőn a korrekciós műtétet követően 7 betegben (5 hét–7 hónap, 3,5–5 kg) mitralis (bileaflet) műbillentyű korai beültetése vált szükségessé. A két műtét közti idő 0–7 nap, de a legkisebb csecsemőnél intenzív kezelés mellett 38 napot kellett várni az annulus feltágulására, hogy a legkisebb műbillentyű beültethető lehessen. A műbillentyűk típusa: 16 mm-es Carbomedics 2, 16 mm-es ATS 3, 17 mm-es Sorin 1, 19 mm-es Sorin 1. Congenitalis mitralis stenosis, illetve insufficientia miatt 2-2 csecsemőbe kellett 16 mm-es ATS billentyűt beültetni. Eredmény: 30 napos mortalitás 0. Egy-egy csecsemő a 46., illetve a 71. posztoperatív napon szepszisben meghalt. 1–6 (átlag 3) éves utánkövetés: 1 betegben kellett pannust eltávolítani, a betegek panaszmentesek. Az antikoaguláns terápia helyes beállítása nehézséget jelentett. Összefoglalás: Congenitalis mitralis stenosis és elégtelenség, valamint a CAVD sebészi korrekciója már kis súlyú újszülötteken is sikerrel elvégezhető. Kedvezőtlen anatómiai helyzetben a mitralis billentyű kialakításának lehetetlensége esetén csak a műbillentyű-beültetés a megoldás. Ez kilátástalannak tűnő helyzetben (kis mitralis annulus) is elvégezhető jó eredménnyel. (Tudomásunk szerint 3500 g súlyú betegünk a legkisebb, sikeresen operált eset.) Ezt igazolják eseteink korai és középtávú eredményei.

Post-operative left atrioventricular valve function after the staged repair of complete atrioventricular septal defect with tetralogy of Fallot

2014 ◽  
Vol 62 (10) ◽  
pp. 602-607 ◽  
Author(s):  
Kazuki Morimoto ◽  
Takaya Hoashi ◽  
Koji Kagisaki ◽  
Kenichi Kurosaki ◽  
Isao Shiraishi ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Atrioventricular Valve ◽  
Complete Atrioventricular Septal Defect ◽  
Valve Function ◽  
Complete Atrioventricular
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