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Ann Thorac Surg 1989;48:544-550
© 1989 The Society of Thoracic Surgeons

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Articles

Intraoperative Evaluation of Atrioventricular Septal Defect Repair by Color Flow Mapping Echocardiography

Division of Pediatric Cardiology, Edward Mallinckrodt Department of Pediatrics, Division of Cardiothoracic Surgery, Department of Surgery, and the Mallinckrodt Institute of Radiology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri

Accepted for publication June 16, 1989.

^* Address reprint requests to Dr Canter, St. Louis Children's Hospital, 400 S Kingshighway Blvd, St. Louis, MO 63110

Despite improving survival rates after repair of atrioventricular septal defect, many patients require reoperation because of postoperative heart failure. We used intraoperative color flow mapping echocardiography to assess the results of surgical repair of atrioventricular septal defect in 19 consecutive patients and compared those findings with results three to five days and 3 to 11 months after repair. There was close correlation between intraoperative and postoperative color flow mapping echocardiography in estimating the presence and severity of left atrioventricular valve regurgitation. All patients survived surgical repair, but in 4 (21%), postoperative congestive heart failure due to left atrioventricular valve regurgitation developed. The need for reoperation was significantly correlated with the severity of left atrioventricular valve regurgitation (r = 0.68) as estimated by intraoperative echocardiography and preoperative aberrancies in the atrioventricular valve (r = 0.68). Age, weight, additional congenital heart disease, preoperative pulmonary vascular resistance, preoperative atrioventricular valve regurgitation, and postoperative mean pulmonary arterial or left atrial pressure were not significantly correlated with the need for reoperation. Intraoperative color flow mapping echocardiography can accurately predict the development of early postoperative heart failure and subsequent reoperation after surgical repair of atrioventricular septal defect.

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