Surgical treatment of complete A-V canal defects in children before 3 months of age

• Published in: European journal of cardio-thoracic surgery 2003-02, Vol.23 (2), p.187-193
• Main Authors: Stellin, G., Vida, V.L., Milanesi, O., Rizzoli, G., Rubino, M., Padalino, M.A., Bonato, R., Casarotto, D.
• Format: Article
• Language: English
• Subjects: Age Factors; Child; Child, Preschool; Complete A-V canal defects; Female; Follow-Up Studies; Heart Septal Defects - mortality; Heart Septal Defects - surgery; Humans; Infant; Logistic Models; Male; Reoperation; Risk; Surgical treatment; Treatment Outcome
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(02)00760-1

Objectives: Surgical repair of complete A-V canal defects (CAVCD) is a well established procedure which is currently performed in infancy. The aim of this study is to evaluate surgical results of correction in early infancy in comparison to older age. Methods: From January 1985 to March 2001, 119 consecutive patients (age range 27 days to 83 months, mean 6.7 months) underwent repair of CAVCD in our Institution. Forms with unbalanced ventricles in association with Fallot's tetralogy or heterotaxia were excluded from this series. Fifty-eight patients (49%) underwent correction before 3 months of age (Group A), and 61 patients (51%) after 3 months (Group B). Surgical repair was accomplished with a double patch technique in 100 patients (84%). Associated surgical lesions were treated simultaneously in 48 patients (40%). Results: There were 11 operative deaths (3 months is, compared to an age ≤3 months, an incremental risk factor for hospital mortality with an odds ratio of 4.8 (95% confidence limit 1–23.5) (P=0.05). In the long term, freedom from reoperation for left A-V valve incompetence is higher when compared to children repaired at an older age.