ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Magdi Yacoub
Darryl F. Shore
Elliot A. Shinebourne
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Al-Hay, A. A.
Right arrow Articles by Shinebourne, E. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Al-Hay, A. A.
Right arrow Articles by Shinebourne, E. A.
Related Collections
Right arrow Congenital - cyanotic

Ann Thorac Surg 2003;75:412-421
© 2003 The Society of Thoracic Surgeons

Original article: cardiovascular

Complete atrioventricular septal defect, Down syndrome, and surgical outcome: risk factors

Amira A. Al-Hay, MRCPa*, Stephanie J. MacNeill, MSb, Magdi Yacoub, FRSc, Darryl F. Shore, FRCSc, Elliot A. Shinebourne, FRCPa

a Department of Paediatric Cardiology, Royal Brompton and Harefield NHS trust, NHLI, Imperial College, Salmia, Kuwait
b Department of Occupational and Environmental Medicine, Royal Brompton and Harefield NHS trust, NHLI, Imperial College, Salmia, Kuwait
c Department of Cardiac Surgery, Royal Brompton and Harefield NHS Trust, NHLI, Imperial College, London, United Kingdom

Accepted for publication July 8, 2002.

* Address reprint requests to Dr Al-Hay, Chest Hospital, P.O. Box 4278, 22043 Salmia, Kuwait.
e-mail: amira_alhay{at}hotmail.com

BACKGROUND: This study was conducted to evaluate surgical outcome and to identify risk factors for hospital mortality and reoperation after repair of complete atrioventricular septal defect.

METHODS: A total of 147 consecutive children underwent repair between January 1986 and December 1998. Of those, 106 had Down syndrome, 37% had normal chromosomes, and 4 had other syndromes; 108 underwent primary repair, 19 had prior pulmonary artery banding, and 20 had additional tetralogy of Fallot. The median weight at primary repair was 4.5 kg. A two-patch technique was used in 88%.

RESULTS: The 30-day mortality was 15% (70% confidence interval [CI] 12% to 19%). A double orifice atrioventricular valve was found to be a significant risk factor (p = 0.002), with 6 of 11 patients dying. If double orifice atrioventricular valve patients are excluded, the mortality rate falls to 12% (70% CI 9% to 15%). No difference in mortality was found between Down syndrome and chromosomally normal children but the latter more commonly required reoperation. Chromosomally normal children frequently have a dysplastic common atrioventricular valve (24% versus 3% in Down children, p < 0.001). In a multivariate Cox model including both variables, the presence of a dysplastic atrioventricular valve was a significant risk factor for reoperation. After controlling for the presence of a dysplastic atrioventricular valve, Down syndrome retained a significant protective effect but the upper limit of the confidence interval was close to 1.

CONCLUSIONS: The presence of a double orifice atrioventricular valve emerged as an unforeseen risk factor for death.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
S. Abadir, V. Fouilloux, D. Metras, O. Ghez, B. Kreitmann, and A. Fraisse
Isolated cleft of the mitral valve: distinctive features and surgical management.
Ann. Thorac. Surg., September 1, 2009; 88(3): 839 - 843.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. M. Stulak, H. M. Burkhart, J. A. Dearani, H. V. Schaff, F. Cetta, R. D. Barnes, and F. J. Puga
Reoperations After Initial Repair of Complete Atrioventricular Septal Defect.
Ann. Thorac. Surg., June 1, 2009; 87(6): 1872 - 1878.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. H. Shuhaiber, S. Y. Ho, M. Rigby, and B. Sethia
Current options and outcomes for the management of atrioventricular septal defect
Eur. J. Cardiothorac. Surg., May 1, 2009; 35(5): 891 - 900.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
R. Formigari, G. Michielon, M. C. Digilio, G. Piacentini, A. Carotti, A. Giardini, R. M. Di Donato, and B. Marino
Genetic syndromes and congenital heart defects: how is surgical management affected?
Eur. J. Cardiothorac. Surg., April 1, 2009; 35(4): 606 - 614.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. Dodge-Khatami, S. Herger, V. Rousson, M. Comber, W. Knirsch, U. Bauersfeld, and R. Pretre
Outcomes and reoperations after total correction of complete atrio-ventricular septal defect
Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 745 - 750.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Locker, J. A. Dearani, P. W. O'Leary, and F. J. Puga
Endoluminal Pulmonary Artery Banding: Technique, Applications and Results
Ann. Thorac. Surg., August 1, 2008; 86(2): 588 - 595.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. Lange, T. Guenther, R. Busch, J. Hess, and C. Schreiber
The presence of Down syndrome is not a risk factor in complete atrioventricular septal defect repair
J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 304 - 310.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
Y.-Q. Lai, Y. Luo, C. Zhang, and Z.-G. Zhang
Utilization of Double-Orifice Valve Plasty in Correction of Atrioventricular Septal Defect
Ann. Thorac. Surg., April 1, 2006; 81(4): 1450 - 1454.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. K. Kim, W.-H. Kim, S. W. Hwang, J. Y. Lee, J. Y. Song, S.-J. Kim, and K. Y. Jang
Predictive Value of Intraoperative Transesophageal Echocardiography in Complete Atrioventricular Septal Defect
Ann. Thorac. Surg., July 1, 2005; 80(1): 56 - 59.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. Masuda, H. Kado, Y. Tanoue, K. Fukae, T. Onzuka, Y. Shiokawa, T. Shirota, and H. Yasui
Does Down syndrome affect the long-term results of complete atrioventricular septal defect when the defect is repaired during the first year of life?
Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 405 - 409.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. D. J. Ten Harkel, A. H. Cromme-Dijkhuis, B. C.C. Heinerman, W. C. Hop, and A. J.J.C. Bogers
Development of Left Atrioventricular Valve Regurgitation After Correction of Atrioventricular Septal Defect
Ann. Thorac. Surg., February 1, 2005; 79(2): 607 - 612.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. A.A. Al-Hay, C. R. Lincoln, D. F. Shore, and E. A. Shinebourne
The left atrioventricular valve in partial atrioventricular septal defect: management strategy and surgical outcome
Eur. J. Cardiothorac. Surg., October 1, 2004; 26(4): 754 - 761.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
N. Sekarski, P. Fridez, A. F. Corno, L. K. von Segesser, and E. J. Meijboom
Doppler-guided regulation of a telemetrically operated adjustable pulmonary banding system
J. Am. Coll. Cardiol., September 1, 2004; 44(5): 1087 - 1094.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. Formigari, R. M. Di Donato, G. Gargiulo, D. Di Carlo, C. Feltri, F. M. Picchio, and B. Marino
Better surgical prognosis for patients with complete atrioventricular septal defect and Down's syndrome
Ann. Thorac. Surg., August 1, 2004; 78(2): 666 - 672.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2003 by The Society of Thoracic Surgeons.