본문 바로가기
KERD
논문KCI 등재

Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류의학일반

초록

Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0–7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5–5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006–0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

Abstract

Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0–7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5–5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006–0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

참고문헌 (14)

  1. Pacifico AD, "Surgery for congenital heart defects", pp.373~386 (2006), John Wiley & Sons
  2. Rastelli G, "Anatomic observations on complete form of persistent common atrioventricular canal with special reference to atrioventricular valves", Mayo Clin Proc, 41, pp.296~308 (1966)
  3. Wilcox BR, "Anatomically sound, simplified approach to repair of"complete"atrioventricular septal defect", Ann Thorac Surg, 64, pp.487~494 (1997)
  4. Nicholson IA, "Simplified single patch technique for the repair of atrioventricular septal defect", J Thorac Cardiovasc Surg, 118, pp.642~646 (1999)
  5. Reynen S, "Long-term outcome up to 40 years after single patch repair of complete atrioventricular septal defect in infancy or childhood", Thorac Cardiovasc Surg, 69(Suppl 3), pp.e68~75 (2021)
  6. Stephens EH, "Teaching the modified single-patch technique for complete atrioventricular septal defect", World J Pediatr Congenit Heart Surg, 13, pp.371~375 (2022)
  7. Cantinotti M, "Echocardiographic examination of mitral valve abnormalities in the paediatric population : current practices", Cardiol Young, 30, pp.1~11 (2020)
  8. Geoffrion TR, "A review of the Nunn modified single patch technique for atrioventricular septal defect repair", Transl Pediatr, 7, pp.91~103 (2018)
  9. Azzab S, "The effect of surgical technique, age, and trisomy 21 on early outcome of surgical management of complete atrioventricular canal defect", Cardiol Young, 32, pp.869~873 (2022)
  10. Ginde S, "Long-term outcomes after surgical repair of complete atrioventricular septal defect", J Thorac Cardiovasc Surg, 150, pp.369~374 (2015)
  11. Houck CA, "Dysrhythmias in patients with a complete atrioventricular septal defect : from surgery to early adulthood", Congenit Heart Dis, 14, pp.280~287 (2019)
  12. Backer CL, "Modified single-patch technique : repairing complete atrioventricular septal defect", Ann Pediatr Cardiol, 2, pp.51~54 (2009)
  13. Di Mambro C, "Bradyarrhythmias in repaired atrioventricular septal defects : single-center experience based on 34 years of follow-up of 522 patients", Pediatr Cardiol, 39, pp.1590~1597 (2018)
  14. Backer CL, "Modified single patch : are we still worried about subaortic stenosis?", Ann Thorac Surg, 99, pp.1671~1676 (2015)

관련 논문AI추천

Reversibility of Pulmonary Hypertension Following Surgical Atrial Septal Defect Closure in Children with Down SyndromeEun Jung Bae, Gi Beom Kim, Hye Won Kwon, Jae Gun Kwak, Jeong Ryul Lee, Jue Seong Lee, Mi Kyoung Song, Sang Yun Lee, Seul Gi Cha, Woong Han Kim한국심초음파학회 · Journal of Cardiovascular Imaging2019 · 제27권 제4호영아기 심실중격결손 봉합술의 임상적 고찰김세연, 이동협, 이장훈, 이정철, 정태은, 지대림, 한승세영남대학교 의과대학 · Journal of Yeungnam Medical Science2002 · 제19권 제2호Successful Fontan Completion of a Single Ventricle with Floating Dysplastic Right Ventricle within the Left VentricleEun Jung Bae, Gi Beom Kim, Jong Woo Hahn, Mi Kyung Song, Sang-Yun Lee한국심초음파학회 · Journal of Cardiovascular Imaging2021 · 제29권 제3호Early postoperative arrhythmias after pediatric congenital heart disease surgery: a 5-year audit from a lower- to middle-income countryAkhtar Saleem, Alisha Raza Kazmi, Anwar ul Haque, Asma Akbar Ladak, Fatima Mahmood, Muhammad Kamran Younis Memon, Russell Seth Martins, Sidra Ishaque대한중환자의학회 · Acute and Critical Care2022 · 제37권 제2호Outcomes in Neonates with Pulmonary Atresia and Intact Ventricular Septum Underwent Pulmonary Valvulotomy and Valvuloplasty Using a Flexible 2-French Radiofrequency CatheterHan-Yao Chiu, Ing-Sh Chiu, Lon-Yen Tsao, Meng-Luen Lee, Ming Chen연세대학교의과대학 · Yonsei Medical Journal2009 · 제50권 제2호Pulsatility Index in Different Modifications of Fontan Palliation: An Echocardiographic AssessmentAbdullah Sedaghat, Alireza Dehestani, Aliyeh Nikdoost, Manizheh Ahani, Minoo Dadkhah, Mitra Rahimzadeh, Mohammad Ali Navabi, Parvin Akbari Asbagh, Reza Shabanian, Zahra Esmaeeli한국심초음파학회 · Journal of Cardiovascular Imaging2022 · 제30권 제2호

이 간행물의 다른 논문 (16건)