title: Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of incomplete atrioventricular septal defect.
abstract: BACKGROUND
  Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect.
  
  
  OBJECTIVE
  To determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect.
  
  
  METHODS
  We assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative left atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. The median age was 4.1 years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the time of preoperative evaluation, there were 23 cases with moderate or greater left atrioventricular valve regurgitation (45.1%). Abnormalities on the left atrioventricular valve were found in 17.6%; annuloplasty was performed in 21.6%.
  
  
  RESULTS
  At the time of postoperative evaluation, there were 12 cases with moderate or greater left atrioventricular valve regurgitation (23.5%). The variation between pre- and postoperative grades of left atrioventricular valve regurgitation of patients with atrioventricular valve malformation did not reach significance (P=0.26), unlike patients without such abnormalities (P=0.016). During univariate analysis, only absence of Down syndrome was statistically significant (P=0.02). However, after a multivariate analysis, none of the factors reached significance.
  
  
  CONCLUSIONS
  None of the factors studied was determinant of a moderate or greater left atrioventricular valve regurgitation within the first 30 days of repair of incomplete atrioventricular septal defect in the sample. Patients without abnormalities on the left atrioventricular valve benefit more of the operation.
authors.affiliation: Department of Pediatrics and Pediatric Surgery, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil.
authors.forename: Marcelo Felipe
authors.initials: MF
authors.lastname: Kozak
authors.affiliation: Department of Pediatrics and Pediatric Surgery, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil.
authors.forename: Ana Carolina Leiroz Ferreira Botelho Maisano
authors.initials: AC
authors.lastname: Kozak
authors.affiliation: Department of Pediatrics and Pediatric Surgery, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: De Marchi
authors.affiliation: Department of Cardiology, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil.
authors.forename: Moacyr Fernandes de
authors.initials: MF
authors.lastname: Godoy
authors.affiliation: Department of Pediatrics and Pediatric Surgery, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil.
authors.forename: Ulisses Alexandre
authors.initials: UA
authors.lastname: Croti
authors.affiliation: Department of Pediatrics and Pediatric Surgery, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil.
authors.forename: Airton Camacho
authors.initials: AC
authors.lastname: Moscardini
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D006343:Heart Septal Defects / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011184:Postoperative Period; D057234:Preoperative Period; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography