title: Atrioventricular septal defect complicated by right ventricular outflow tract obstruction. Analysis of risk factors regarding surgical repair.
abstract: Eighteen patients with complete atrioventricular septal defect (AVSD) were found to have either associated tetralogy (n = 15) or pulmonary atresia (n = 3). Their pre- and post-operative course was reviewed focusing attention on risk factors for complete repair. These included right ventricular (RV) hypoplasia, identified by cineangiographic volume determinations in two cases (11%) and inadequate pulmonary artery size in one patient. In the 2 cases with RV hypoplasia and in one case, in whom all chordae of the AV valve were connected to a single right ventricular papillary muscle (AVSD type Rastelli B), complete repair was not feasible. In addition, angiography revealed coronary artery variations in 5/18 (28%), which did not preclude surgical repair. Palliative surgery was undertaken in 10 patients and complete repair carried out in five. Six of 18 patients died, 2 among those after complete repair.
authors.affiliation: Kinderklinik, Deutsches Herzzentrum München, W. Germany.
authors.forename: M
authors.initials: M
authors.lastname: Vogel
authors.forename: U
authors.initials: U
authors.lastname: Sauer
authors.forename: K
authors.initials: K
authors.lastname: Bühlmeyer
authors.forename: F
authors.initials: F
authors.lastname: Sebening
mesh_terms: D002306:Cardiac Volume; D005260:Female; D006343:Heart Septal Defects / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011664:Pulmonary Valve / Q000002:abnormalities; D011859:Radiography; D012307:Risk Factors; D013771:Tetralogy of Fallot / Q000150:complications; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*