目的:在过去的几十年中,房室间隔缺损(AVSD)患者的外科修复技术和治疗取得了进展。早期和明确的干预措施已成为这些患者的治疗选择。基于这样的背景,我们旨在回顾原发性AVSD修复的早期和中期结局.
方法:在2014年1月至2021年6月期间,共有53例平均年龄为3.45±5.67岁的患者接受了AVSD的确定性修复。临床数据包括年龄,缺陷类型,相关的共同异常,症状,肺动脉高压,等。进行回顾性收集和评估。在0、1、2和5年评估作为临床结果的二尖瓣返流(MR)。
结果:在招募的患者中,男性35人(66.1%),女性18人(33.9%)。53名患者中,38例(71.69%)患者完成了完全缺损的修复,15例(23.1%)患者进行了中度/部分缺损的修复,一名患者接受了不完整类型的修复。其他相关的共同异常是二尖瓣前小叶(12(22.6%)),心房和室间隔缺损(VSD)(30(56.6%)),和动脉导管未闭(PDA)(11(20.8%))。手术修复的不同程序包括补片闭合,裂隙修复,和聚四氟乙烯(PTFE)VSD闭合。修复后,平均随访时间为46.73±27.37个月。总死亡率为3.78%(2/53),两名患者因有症状的严重MR接受了再干预。
结论:对AVSD的明确和及时的校正显示出令人满意的早期和中期结果。
OBJECTIVE: Surgical repair techniques and management of patients with atrioventricular septal defect (AVSD) have progressed over the last few decades. Early and definitive interventions have become the choice of treatment for these patients. Based on this background, we aimed to review the early and mid-term outcomes of primary AVSD repair.
METHODS: A total of 53 patients with a mean age of 3.45 ± 5.67 years underwent definitive repair for AVSD between January 2014 and June 2021. The clinical data including age, type of defect, associated co-anomalies, symptoms, pulmonary hypertension, etc. were collected and assessed retrospectively. Mitral regurgitation (MR) as a clinical outcome was assessed at 0, 1, 2, and 5 years.
RESULTS: Among the recruited patients, 35 (66.1%) were male and 18 (33.9%) were female. Of 53 patients, repair for the complete defect was done in 38 (71.69%) patients, repair for intermediate/partial defect was done in 15 (23.1%) patients, and one patient underwent repair for incomplete type. Other associated co-anomalies were anterior mitral leaflet (12 (22.6%)), atrial and ventricular septal defect (VSD) (30 (56.6%)), and patent ductus arteriosus (PDA) (11 (20.8%)). Different procedures for surgical repair included patch closure, cleft repair, and polytetrafluoroethylene (PTFE) VSD closure. After repair, the mean follow-up period was 46.73 ± 27.37 months. Overall mortality was 3.78% (2/53), and two patients underwent reintervention due to symptomatic severe MR.
CONCLUSIONS: A definitive and timely correction of AVSD shows satisfactory early and mid-term results.