title: Post-operative left atrioventricular valve function after the staged repair of complete atrioventricular septal defect with tetralogy of Fallot.
abstract: OBJECTIVE
  This study reviewed surgical outcomes of staged repair for complete atrioventricular septal defect with tetralogy of Fallot, especially with focusing on the post-operative left-sided atrioventricular valve function.
  
  
  METHODS
  Between 1992 and 2013, 10 patients with complete atrioventricular septal defect with tetralogy of Fallot underwent total correction by the following surgical strategy. Systemic-to-pulmonary shunt was placed at first at the mean age of 1.5 ± 1.3 months. Then confirming sufficient development of the left heart structures, the total correction was performed at the mean age of 1.4 ± 0.6 years. Second shunt was required in 4 (40 %) patients to develop the left heart structures.
  
  
  RESULTS
  The left ventricular end-diastolic volume before total correction was 127 ± 30 % of normal size. The two-patch repair was applied in 8 (80 %) patients. There was no mortality, and 1 reoperation case for left-sided atrioventricular valve regurgitation. The follow-up was completed on all patients and the mean follow-up period was 7.4 ± 7.0 years. The post-operative left-sided atrioventricular valve regurgitation kept less than moderate for 10-year follow-up in all patients except one patient who required the repair of left-sided atrioventricular valve 1 year after the total correction.
  
  
  CONCLUSIONS
  The post-operative left-sided atrioventricular valve function after the repair of complete atrioventricular septal defect with tetralogy of Fallot maintained with the application of the two-patch repair, early and repeated palliative systemic-to-pulmonary shunt, and the early definitive surgery.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Morimoto
authors.forename: Takaya
authors.initials: T
authors.lastname: Hoashi
authors.forename: Koji
authors.initials: K
authors.lastname: Kagisaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kurosaki
authors.forename: Isao
authors.initials: I
authors.lastname: Shiraishi
authors.forename: Hajime
authors.initials: H
authors.lastname: Ichikawa
mesh_terms: D006348:Cardiac Surgical Procedures / Q000401:mortality; D005260:Female; D006343:Heart Septal Defects; D006801:Humans; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D011182:Postoperative Care; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology