title: Primary repair of complete atrioventricular septal defect in infancy.
abstract: Forty infants with complete atrioventricular septal defect have undergone primary repair within their 1st year of life. The mean age at time of surgery was 4 months (range 1-12 months) and the mean weight 4.2 kg (range 2.9-7.0 kg). Either the one- or the two-patch method was used. Four patients died (10%). There were no late deaths. Three patients needed reoperation due to mitral valve insufficiency. Postoperative complications were: 1 total atrioventricular block in an infant with an absent ventricular septum 3 weeks after surgery, 9 complete right bundle branch blocks, 3 small residual ventricular septal defects. Mean follow-up of the 36 survivors is 22 months (3-46 months). Thirty (83%) are in NYHA functional class I, 4 (11%) in NYHA class II and 2 (6%) in NYHA class III. No atrioventricular valve regurgitation is detectable by the color Doppler technique in 19 (53%) patients. Mitral incompetence is mild in 13 cases (36%) and moderate in 4 (11%). In ten recatheterized patients the average systolic pulmonary to systemic artery pressure ratio dropped from 1.0 to 0.42 and the average pulmonary arteriolar resistance was reduced from 5.5 to 3.9 U/m2. All but one patient gained weight and underwent adequate statomotoric development. Primary repair should be performed at the age of 5-6 months or even earlier, if pulmonary arteriolar resistance exceeds 5 U/m2.
authors.affiliation: Department of Pediatric Cardiology, Ruhr University of Bochum, Bad Oeynhausen, FRG.
authors.forename: W R
authors.initials: WR
authors.lastname: Thies
authors.forename: T
authors.initials: T
authors.lastname: Breymann
authors.forename: W
authors.initials: W
authors.lastname: Matthies
authors.forename: E
authors.initials: E
authors.lastname: Crespo-Martinez
authors.forename: H
authors.initials: H
authors.lastname: Meyer
authors.forename: R
authors.initials: R
authors.lastname: Körfer
mesh_terms: D006328:Cardiac Catheterization; D005260:Female; D005500:Follow-Up Studies; D006343:Heart Septal Defects / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D011669:Pulmonary Wedge Pressure; D012086:Reoperation