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Ann Thorac Surg 1989;48:413-416
© 1989 The Society of Thoracic Surgeons

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Articles

Long-Term Results After Surgical Repair of Incomplete Endocardial Cushion Defects

Division of Cardiothoracic Surgery, University Hospital, and Department of Surgery, University of Florida College of Medicine, Jacksonville, Florida; Department of Cardiovascular Surgery, Children's Hospital National Medical Center, Washington, DC; and Department of Surgery and Department of Child Health and Development, George Washington University, Washington, DC

Accepted for publication June 12, 1989.

^* Address reprint requests to Dr Ceithaml, University Hospital of Jacksonville, 655 West 8th Street, Jacksonville, FL 32209

	Abstract

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Since 1964, 56 children (mean age, 6.7 years) underwent repair of incomplete endocardial cushion defects. Forty patients had isolated ostium primum defects. Additional congenital defects were present in 17 patients (30%). All patients underwent patch closure of the ostium primum defect and 47 of 56 patients (84%) underwent mitral valvuloplasty. Hospital mortality was 1.8% (one death). Arrhythmias developed in 7 other patients in the early postoperative period, of which six were transient and resolved completely. One patient required early pacemaker placement for complete heart block. Cumulative follow-up was 378 patient-years. There were three late deaths (5.7%), and additional operations were required in 12 patients (22.6%). Seven of these 12 patients required mitral valve replacement for severe mitral regurgitation. The mean interval between initial repair and mitral valve replacement was 4.2 years, with only three valves needing replacement within 12 months. There was a significant correlation between the severity of mitral regurgitation before initial repair and subsequent need for mitral valve replacement. Late onset atrial arrhythmias have developed in 6 patients. Current functional status has been evaluated in 50 of 52 surviving patients and 88.5% are in NYHA class I, with the remainder in class II.

	References

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