ATRIOVENTRICULAR-CANAL DEFECTS - RESULTS OF REPAIR IN THE CURRENT ERA

被引：13

作者：

ROSS, DA ^{[1
]}

NANTON, M ^{[1
]}

GILLIS, DA ^{[1
]}

MURPHY, DA ^{[1
]}

机构：

[1] DALHOUSIE UNIV,DIV CARDIOVASC SURG,HALIFAX B3H 4H2,NS,CANADA

来源：

JOURNAL OF CARDIAC SURGERY | 1991年 / 6卷 / 03期

关键词：

D O I：

10.1111/j.1540-8191.1991.tb00332.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Between December 1986 and December 1990, 37 consecutive patients underwent repair of complete atrioventricular (AV) canal with the two-patch technique. Mean age at repair was 22 months and 51% were < 1 year of age. Eighteen (48.6%) had undergone previous palliative operations. Two operative deaths (5.4%) occurred and another patient died in-hospital for an early mortality of 8.1%. One late death (2.9%) has occurred from a respiratory infection. Actuarial survival is 87.7% at 3 years. Small size (p < 0.05), unbalanced ventricular size (p < 0.05), New York Heart Association (NYHA) Class IV (p < 0.05), and severe preoperative AV valve insufficiency (p < 0.05) were significant preoperative risk factors for death. Five survivors (14.7%) required reoperation for severe AV valve insufficiency (two) or patch leaks (three). The risk for reoperation was increased in non-Down's patients (p < 0.02). All survivors are in NYHA Class I (93%) or II (7%). The risk for early AV valve insufficiency was increased in patients who did not have the cleft sutured (p < 0.05), and in those with unbalanced ventricles (p < 0.01). Risk of late AV valve insufficiency was increased only by small size (p < 0.02). Previous pulmonary artery banding did not increase the risk of repair or of postoperative AV valve insufficiency. Complete AV canal can be repaired with low mortality. Pulmonary artery banding may still have a role to play in the very small (4-5 kg) infant in refractory heart failure.

引用

页码：367 / 372

页数：6

共 9 条

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