title: Repair of partial atrioventricular septal defect: a 37-year experience.
abstract: OBJECTIVE
  Partial atrioventricular septal defect (pAVSD) is routinely repaired with a low mortality. However, limited data are available on the long-term follow-up of these patients. The current study was designed to determine long-term survival and morbidity of a large cohort of patients operated on at a single institution.
  
  
  METHODS
  From 1975 to 2012, 249 consecutive patients underwent pAVSD repair at the Royal Children's Hospital. The follow-up data were obtained from hospital records, correspondence with cardiologists and primary care physicians, patient surveys and the state death registry.
  
  
  RESULTS
  The early mortality rate was 1.2% (3/249), while the long-term survival rate was 96% (95% CI: 93-98%) at 10 years and 94% (95% CI: 89-97%) at 30 years. Freedom from reoperation was 84% at 10 years and 75% at 30 years. The most common reoperations were left atrioventricular valve surgery (30/249, 12.1%), resection of left ventricular outflow tract obstruction (12/249, 4.8%) and closure of residual atrial septal defects (5/249, 2.0%). Implantation of a permanent pacemaker was required in 3.2% (8/249) of patients. Despite a substantial reoperation rate, only 43% of patients older than 18 years of age were seen by a cardiologist within the most recent 2 years of the study period, compared with 80% of those younger than 18 years (P < 0.001).
  
  
  CONCLUSIONS
  Repair of pAVSD is performed with a low mortality and excellent long-term survival. However, a substantial reoperation rate warrants close follow-up into adulthood.
authors.affiliation: Cardiac Surgery Unit, The Royal Children's Hospital, Melbourne, Australia The University of Melbourne, Melbourne, Australia Murdoch Children's Research Institute, Melbourne, Australia igor.konstantinov@rch.org.au.
authors.forename: Edward
authors.initials: E
authors.lastname: Buratto
authors.affiliation: Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: McCrossan
authors.affiliation: Murdoch Children's Research Institute, Melbourne, Australia Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
authors.forename: John C
authors.initials: JC
authors.lastname: Galati
authors.affiliation: Princess Margaret Hospital, Perth, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bullock
authors.affiliation: Women's and Children's Hospital, Adelaide, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kelly
authors.affiliation: Cardiac Surgery Unit, The Royal Children's Hospital, Melbourne, Australia The University of Melbourne, Melbourne, Australia Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Yves
authors.initials: Y
authors.lastname: d'Udekem
authors.affiliation: Cardiac Surgery Unit, The Royal Children's Hospital, Melbourne, Australia The University of Melbourne, Melbourne, Australia Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Brizard
authors.affiliation: Cardiac Surgery Unit, The Royal Children's Hospital, Melbourne, Australia The University of Melbourne, Melbourne, Australia Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Igor E
authors.initials: IE
authors.lastname: Konstantinov
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006345:Heart Septal Defects, Ventricular / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
keywords: Congenital heart disease; Outcomes; Septal defects