Repair for partial and complete atrioventricular septal defect: Single centre experience and long-term results

Background: The number of adult patients with surgical repaired congenital heart defects increases continuously. We were interested to compare late outcome after partial and complete atrioventricular defect repair (pAVSD and cAVSD, respectively) and to determine the most important reason for re-intervention. Methods: All patients older than 16 years, who underwent partial or complete atrioventricular defect repair, were selected from the database. The medical files were reviewed for descriptive statistics. Kaplan Meier analysis was used to determine event free survival for both groups. Log rank testing was peformed where applicable. Results: One hundred thirty-eight patients were included. Two patients in each group with early postoperative mortality were excluded (pAVSD: 33/30 male/female, mean age 35.9 +/- 15.6 years; cAVSD: 27/ 44 male/female, mean age 25.7 +/- 11.9 years). Fourteen pAVSD-patients and 23 cAVSD-patients needed a surgical re-intervention: in two and 13 patients, respectively, a mitral valve repair was performed, and in five and one patient, respectively, a mechanical valve was replaced. Eight cAVSD-patients and 10 pAVSD-patients developed atrial arrhythimas. Seven patients (3 cAVSD and 4 pAVSD) received a pacemaker. Median event-free survival time was significantly shorter in the cAVSD-group (22.9 (95% Cl 15.4-30.5) years) when compared to the pAVSD-group (34.0 (95% Cl 20.1-47.9) years) (Log rank testing, P=0.017). Conclusion: Late outcome was characterized by a longer event free follow-up time of pAVSD-patients when compared to cAVSD-patients. The most important reason for re-intervention in both groups was mitral valve regurgitation. However, atrial arrhythmias and conduction disorders were not uncommon late after atrioventricular septal defect repair.