[Long-term results of complete atrio-ventricular canal correction].
OBJECTIVE
To assess the prognosis of surgically corrected complete atrio-ventricular canal and determine risk factors for death and redo surgery.


METHODS
and method: From January 1984 to March 2006, 126 patients were distributed in 3 groups according to their date of intervention: group I (1984-1991), group II (1992-1999) and group III (2000-2006). They were operated at mean age of 8.35 + 13.3 months. Down syndrome was present in 99 patients (79%). A partial or total closure of the left atrio-ventricular valvular cleft was performed in 47 patients (37%).


RESULTS
The in-hospital mortality was at 14.28% (18 patients), including 23.7% in group I, 16.2% in group II and 4.4% in group III (p=0.06). The predictive factors of survival were the Down syndrome (p<0.05) and surgery of the left atrio-ventricular valvular cleft (p=0.05). An early reoperation was required in 6 cases, for a severe leak of this valve (n=4) or an important residual shunt (n=2). After a mean follow-up of 9.5+6.9 years, the survival rate was at 83.6% and 10 patients (9.9%) had a redo surgery for a leak of the left atrio-ventricular valve (n=6) or sub-aortic stenosis (n=4). The rate of no-redo surgery for valve insufficiency was at 94.2% at 5 years, 91.1% at 10 years and 87.6% at 15 years.


CONCLUSIONS
The surgical treatment of complete atrio-ventricular canal became more and more efficient with poor rates of mortality and redo surgery during these last years. The closure of the left atrio-ventricular valve cleft, mostly partial, is frequently performed. Patients with the Down syndrome have a better vital prognosis and lower rates of long-term redo surgery.
Dragulescu
A
A
Cardiologie pédiatrique, Département de cardiologie, Hôpital d'Enfants de La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05.
Ghez
O
O
Fraisse
A
A
Gaudart
J
J
Amedro
P
P
Kreitmann
B
B
Metras
D
D
D001020:Aortic Stenosis, Subvalvular / Q000601:surgery; D002423:Cause of Death; D004314:Down Syndrome / Q000150:complications; D004694:Endocardial Cushion Defects / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008944:Mitral Valve Insufficiency / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome