title: Surgery for partial atrioventricular septal defect in the adult.
abstract: BACKGROUND
  We sought to determine the clinical profile, operative results, and long-term outcome for adult patients undergoing operations for partial atrioventricular septal defects.
  
  
  METHODS
  Between 1976 and 1996, 50 adults (mean age, 36.6 +/- 13.2 years) underwent surgery for partial atrioventricular septal defects. Thirty-nine of them underwent primary repair for a substantial left-to-right shunt (> or =1.8), associated with symptoms in 29. The remaining 11 patients had previous atrioventricular septal defect repair in childhood, but required reoperation as adults for severe left atrioventricular valve regurgitation (6), subaortic (3) or mitral (1) stenosis, and a residual atrial shunt (1).
  
  
  RESULTS
  No patients died in hospital. Of the 39 patients first repaired in adulthood, left atrioventricular valve repair was performed in 37, valve replacement in 1, and no repair in 1. In contrast, left atrioventricular valve replacement was necessary in 2 of the 6 adults undergoing reoperation for left atrioventricular valve regurgitation. At 7 years median follow-up, 8 patients have died (2 from noncardiac causes). Of 42 patients alive in 1997, 39 are New York Heart Association class I or II, and 3 were class III (class improved in 81%). Two patients required left atrioventricular valve replacement (1 week and 5 years after repair, respectively) for valvar failure.
  
  
  CONCLUSIONS
  Low operative risk and excellent long-term results support repair of partial atrioventricular septal defect in adults.
authors: The Toronto Congenital Cardiac Centre for Adults, The Toronto Hospital, Ontario, Canada.
authors: M A
authors: MA
authors: Gatzoulis
authors: S
authors: S
authors: Hechter
authors: G D
authors: GD
authors: Webb
authors: W G
authors: WG
authors: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000401:mortality / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D015996:Survival Rate