Congenital Heart Surgeons Society

CHSS Home CHSS Home Past & Future Meetings Past & Future Meetings

Back to 2024 Abstracts


The Fate Of The Left Atrioventricular Valve After Atrioventricular Septal Defect Repair: Long-term Outcomes
Mario O'Connor, MD, Caroline Hughes, BA, Catherine Stauber, BA, Neil M. Venardos, MD, Charles D. Fraser, MD, Carlos M. Mery, MD MPH, Andrew Well, MD MPH MSHCT.
Dell Medical School at The University of Texas at Austin, Austin, TX, USA.

Objective(s):
Repair of complete atrioventricular septal defects(CAVSD) has shown excellent results, necessity for left atrioventricular valve(LAVV) intervention after the initial CAVSD repair presents therapeutic challenges and potential morbidity. Data on incidence and outcomes of LAVV intervention after primary CAVSD repair remain limited. Methods:
Retrospective review of the Pediatric Health Information System(PHIS) from 1/2004-12/2023. All patients who underwent CAVSD repair were included. LAVV reintervention was defined as mitral valve repair or replacement after initial CAVSD. International Classification of Diseases 9/10 codes were used to identify diagnoses and procedures. Results:
7,745 patients underwent CAVSD repair with 4,430(57.4%) females, 4,430(57.2%) Non-Hispanic White, 4,250(54.9%) with Down syndrome and a median age of 5.4[IQR:3.7-10.2] months at repair. Following CAVSD repair, 503(6.5%) required LAVV reintervention, with 405(80.5%) repairs and 98(19.5%) replacements. Median total follow up was 1.99[IQR:0.09-9.13] years. Freedom from reintervention is displayed in the figure. Significant factors in Cox regression for LAVV repair included government insurance(HR:0.72;95%CI:0.57-0.92,p=0.008), age(per-month at CAVSD repair)(HR:0.98;95%CI:0.97-0.99,p<0.001), Down syndrome(HR:0.56;95%CI:0.45-0.88,p=0.006), and middle tertile-volume centers compared to highest tertile(HR:1.24;95%CI:1.00-1.55;p=0.044). For LAVV replacement, Down syndrome(HR:0.47;95%CI:0.30-0.72,p<0.001) was the only significant factor. Conclusions:
In a large multicenter dataset, LAVV reintervention after CAVSD repair is not uncommon. The necessity for LAVV reintervention was frequently followed by the need for additional LAVV interventions. LAVV reintervention continues to be a significant burden for patients with AVSD. Data may be useful for counseling of patients and families.

Back to 2024 Abstracts