Objective: Correction of complete atrioventricular septal defect (AVSD) in infants achieves satisfactory early results. This study outlines the long-term outcomes of all infants at our institution who underwent correction for complete AVSD.
Methods: A total of 104 consecutive infants underwent surgical repairs for complete AVSD between 1991 and 2006. 44 infants were associated with Down syndrome. Health and neurodevelopment (Bayley Scales of Infant Development II) were assessed at 18 to 24 months of age. Multivariate analyses were determined to identify risk factors associated with long-term outcomes.
Results: There were 5 peri-operative deaths. At the average 8-year follow-up, 4 late deaths occurred and reoperation was required in 9 patients for left atrioventricular valve (AVV) regurgitation. At last follow-up, no or only mild left AVV and right AVV regurgitation was present in 79.8% and 92.9% of patients, respectively, and 69.7% of patients were medication-free. Risk factors for reoperation were younger age (<6 months), lower weight (<6kg), and in non-Down children. 57 non-Down children were assessed for neurodevelopment. The mean scores were 86 (45-110) for mental skills and 90 (47-121) for motor skills. Low gestational age, length of postoperative ventilation, and high postoperative lactate was associated with mentally and/or motor-delayed non-Down children.
Conclusion: Complete AVSD can be corrected with good long-term survival; postoperative moderate or more AVV regurgitation could be anticipated in patients <6 months and weighing <6 kg. Neurodevelopmental outcome is a concern, and there may be potentially modifiable postoperative factors that can be optimized to improve developmental outcomes.