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Asian Cardiovasc Thorac Ann 1998;6:37-40
© 1998 Asia Publishing EXchange Pte Ltd

ORIGINAL CONTRIBUTION

Surgical Repair of Complete Atrioventricular Septal Defect

Mohammed Jalal Uddin, PhD, Stojanovic Velimir, MD, Abdul Latif Salama, MD, Babu Othman, DM, Lulu Othman, MRCP, Enamul Haque, MRCP1, Hani Shuhaiber, FRCS

Department of Cardiac Surgery and Cardiology Chest Diseases Hospital, Safat, Kuwait
1 Department of Paediatrics Adan Hospital, Adan, Kuwait
For reprint information contact: Mohammed Jalal Uddin, PhD P.O. Box 4082 Safat 13041, Kuwait Tel:965 481 1615 Fax:965 484 5280
Between January 1988 and March 1996, 40 patients underwent repair of complete atrioventricular septal defect with a two-patch technique and routine atrioventricular valve cleft closure. The mean age of the patients was 10.8 ± 6.9 months and the mean weight was 6.6 ± 2.6 kg. Twenty-three had Down's syndrome and 13 had coexisting cardiac anomalies. Preoperative angiography and echocardiography revealed mild atrioventricular valve regurgitation in 22 patients, moderate regurgitation in 16, and severe regurgitation in the other 2. The mortality was 12.5% (4 early and 1 late deaths). The major cause of death was pulmonary hypertensive crisis. Reoperation was necessary in 3 patients; 2 had atrioventricular valve annuloplasty and one had prosthetic valve replacement. All 3 survived reoperation. Echocardiography at a mean of 32 ± 20 months postoperatively showed mild left atrioventricular valve regurgitation in 32 patients and moderate regurgitation in 3. Management of postoperative pulmonary hypertensive crisis and repair of complete atrioventricular septal defect before the development of high pulmonary vascular resistance may reduce the mortality of this surgical procedure.






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