Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of incomplete atrioventricular septal defect

Introduction

Left atrioventricular valve regurgitation is the most concerning residuallesion after surgical correction of atrioventricular septal defect.

Objective

To determine factors associated with moderate or greater leftatrioventricular valve regurgitation within 30 days of surgical repair ofincomplete atrioventricular septal defect.

Methods

We assessed the results of 51 consecutive patients 14 years-old and youngerpresenting with incomplete atrioventricular septal defect that were operatedon at our practice between 2002 and 2010. The following variables wereconsidered: age, weight, absence of Down syndrome, grade of preoperativeleft atrioventricular valve regurgitation, abnormalities on the leftatrioventricular valve and the use of annuloplasty. The median age was 4.1years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the timeof preoperative evaluation, there were 23 cases with moderate or greaterleft atrioventricular valve regurgitation (45.1%). Abnormalities on the leftatrioventricular valve were found in 17.6%; annuloplasty was performed in21.6%.

Results

At the time of postoperative evaluation, there were 12 cases with moderate orgreater left atrioventricular valve regurgitation (23.5%). The variationbetween pre- and postoperative grades of left atrioventricular valveregurgitation of patients with atrioventricular valve malformation did notreach significance (P=0.26), unlike patients without suchabnormalities (P=0.016). During univariate analysis, onlyabsence of Down syndrome was statistically significant(P=0.02). However, after a multivariate analysis, none ofthe factors reached significance.

Conclusion

None of the factors studied was determinant of a moderate or greater leftatrioventricular valve regurgitation within the first 30 days of repair ofincomplete atrioventricular septal defect in the sample. Patients withoutabnormalities on the left atrioventricular valve benefit more of theoperation.