title: Contemporary outcomes of complete atrioventricular septal defect repair: analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.
abstract: OBJECTIVE
  Contemporary outcomes data for complete atrioventricular septal defect (CAVSD) repair are limited. We sought to describe early outcomes of CAVSD repair across a large multicenter cohort, and explore potential associations with patient characteristics, including age, weight, and genetic syndromes.
  
  
  METHODS
  Patients in the Society of Thoracic Surgeons Congenital Heart Surgery Database having repair of CAVSD (2008-2011) were included. Preoperative, operative, and outcomes data were described. Univariate associations between patient factors and outcomes were described.
  
  
  RESULTS
  Of 2399 patients (101 centers), 78.4% had Down syndrome. Median age at surgery was 4.6 months (interquartile range, 3.5-6.1 months), with 11.8% (n = 284) aged ≤ 2.5 months. Median weight at surgery was 5.0 kg (interquartile range, 4.3-5.8 kg) with 6.3% (n = 151) < 3.5 kg. Pulmonary artery band removal at CAVSD repair was performed in 122 patients (4.6%). Major complications occurred in 9.8%, including permanent pacemaker implantation in 2.7%. Median postoperative length of stay (PLOS) was 8 days (interquartile range, 5-14 days). Overall hospital mortality was 3.0%. Weight < 3.5 kg and age ≤ 2.5 months were associated with higher mortality, longer PLOS, and increased frequency of major complications. Patients with Down syndrome had lower rates of mortality and morbidities than other patients; PLOS was similar.
  
  
  CONCLUSIONS
  In a contemporary multicenter cohort, most patients with CAVSD have repair early in the first year of life. Prior pulmonary artery band is rare. Hospital mortality is generally low, although patients at extremes of low weight and younger age have worse outcomes. Mortality and major complication rates are lower in patients with Down syndrome.
authors.affiliation: Division of Pediatric Cardiac Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minn. Electronic address: stlou012@umn.edu.
authors.forename: James D
authors.initials: JD
authors.lastname: St Louis
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minn.
authors.forename: Upinder
authors.initials: U
authors.lastname: Jodhka
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Jacobs
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Xia
authors.initials: X
authors.lastname: He
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Hill
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Mich.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Pasquali
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md.
authors.forename: Marshall L
authors.initials: ML
authors.lastname: Jacobs
mesh_terms: D000367:Age Factors; D001835:Body Weight; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016208:Databases, Factual; D004314:Down Syndrome / Q000150:complications; D005260:Female; D006343:Heart Septal Defects / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014481:United States