Journal article
Early Outcomes and Prognostic Factors for Left Atrioventricular Valve Reoperation After Primary Atrioventricular Septal Defect Repair
Pediatric cardiology, Vol.33(1), pp.129-140
01/01/2012
DOI: 10.1007/s00246-011-0105-7
PMID: 21910021
Abstract
This study aimed to identify early outcomes of and prognostic factors for left atrioventricular valve (LAVV) reoperation after primary atrioventricular septal defect (AVSD) repair. A retrospective cohort study was performed using the Pediatric Cardiac Care Consortium database, which included 370 patients with previously repaired AVSDs who subsequently underwent LAVV reoperation between 1982 and 2007. Of these patients, 243 underwent LAVV repair, and 127 underwent LAVV replacement. Median time to first reoperation after primary repair was 0.67 years in the repair subgroup and 0.18 years in the replacement subgroup. Thirty-day survival was significantly poorer in the replacement subgroup compared with the repair subgroup (P = 0.0002). In multivariable analysis, independent predictors of earlier time to valve replacement included presence of Down syndrome and postoperative left atrioventricular valve stenosis. Independent predictors of in-hospital death after valve replacement included presence of Down syndrome (hazard ratio [HR] 2.34, 95% CI 1.19-4.58) and prosthetic valve size-to-weight ratio > 3 mm/kg (HR 3.02, 95% CI 1.52-6.01). The identification of a subgroup of previously repaired AVSD patients at high risk for early postoperative death after LAVV replacement suggests that for these patients, a low threshold for detailed hemodynamic monitoring and/or reintervention for hemodynamic aberrations is warranted.
Details
- Title: Subtitle
- Early Outcomes and Prognostic Factors for Left Atrioventricular Valve Reoperation After Primary Atrioventricular Septal Defect Repair
- Creators
- Sonali S. Patel - University of IowaTrudy L. Burns - University of IowaLazaros Kochilas - University of Minnesota Children's Hospital
- Resource Type
- Journal article
- Publication Details
- Pediatric cardiology, Vol.33(1), pp.129-140
- Publisher
- Springer Nature
- DOI
- 10.1007/s00246-011-0105-7
- PMID
- 21910021
- ISSN
- 0172-0643
- eISSN
- 1432-1971
- Number of pages
- 12
- Language
- English
- Date published
- 01/01/2012
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984363621302771
Metrics
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